Complex Reimplantation of Aneurysmal Left Main Coronary Artery During Reoperative Aortic Root Replacement
Brandon Sloan1, Kaitlin Nguyen1, Sean Hamlin1
1Department of General Surgery, St. Luke's University Health Network, Bethlehem, USA.
Insights
Coronary artery fistula (CAF) repair can lead to complications like aneurysms. This study details an innovative surgical technique for repairing an aneurysmal aortic root in adults with prior CAF repair and acquired heart disease.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Aortic Surgery
Background:
- Coronary artery fistula (CAF) is a rare congenital abnormality.
- Literature on managing CAF sequelae, like coronary artery aneurysm in adults with acquired cardiac disease, is limited.
- Adults with congenital heart disease require evolving management strategies for acquired conditions.
Abstract:
Coronary artery fistula (CAF), an aberrant connection between a coronary artery and a chamber of the heart or great vessel, is a rare congenital abnormality for which management has been previously described. However, there remains a paucity of literature on the treatment of sequelae, such as coronary artery aneurysm, in adults with acquired cardiac disease. We present an innovative surgical approach for the repair of an aneurysmal aortic root in a patient with a history of a coronary artery fistula repair and aortic valve replacement. The described operation integrates techniques of advanced aortic surgery with an interposition graft for the reimplantation of a massively dilated left main coronary artery. As life expectancy improves for patients with congenital cardiac abnormalities, the management of acquired cardiac disease must continue to evolve to appropriately treat this population.
