Homograft subclavian interposition graft to left main coronary artery ostium in aortic root replacement

Performing a reoperative root replacement in cases of prosthetic valve endocarditis (PVE) can often be challenging due to significant inflammation and scarring. During these cases, surgeons may decide to utilize an interpositional graft when mobilization of the coronary ostia becomes too hazardous. The authors describe their experience performing a reoperative root replacement on a patient with PVE. In this case, the authors utilize a segment of the homograft left subclavian artery as an interpositional graft to provide an infection-resistant bioprosthetic graft that maintains coronary anatomy.