Intra-atrial coronary artery reconstruction during surgery for cardiac angiosarcoma

A cardiac angiosarcoma is usually located in the right atrium and tends to involve the right coronary artery. Our goal was to report a novel reconstruction technique after en bloc resection of a cardiac angiosarcoma with right coronary artery invasion. This technique includes orthotopic reconstruction of the invaded artery and atrial patch suturing onto the epicardium lateral to the reconstructed right coronary artery. Intra-atrial reconstruction with an end-to-end anastomosis can enhance the graft patency compared to a distal side-to-end anastomosis and can reduce the risk of anastomotic stenosis. Moreover, suturing the graft patch to the epicardium did not increase the risk of bleeding because the pressure in the right atrium was low.