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Reconstruction in left main coronary artery atresia with bypass graft obstruction

Part of: Surgery

Published online by Cambridge University Press:  16 March 2022

Koji Miwa*
Affiliation:
Department of Cardiovascular Surgery, Osaka Women’s and Children’s Hospital, Osaka, Japan
Shigemitsu Iwai
Affiliation:
Department of Cardiovascular Surgery, Osaka Women’s and Children’s Hospital, Osaka, Japan
Toshiaki Nagashima
Affiliation:
Department of Cardiovascular Surgery, Osaka Women’s and Children’s Hospital, Osaka, Japan
*
Author for correspondence: K. Miwa, MD, Department of Cardiovascular Surgery, Osaka Women’s and Children’s Hospital, 840 Murodocho, Izumi, Osaka 594-1101, Japan. Tel: +81 725 561220; Fax: +81 725 565682. E-mail: komiwa0712@gmail.com

Abstract

Paediatric coronary artery bypass surgery with internal thoracic artery grafting is the optimal choice for left main coronary artery atresia; we report successful reconstruction in a patient with bypass graft obstruction. The pulmonary trunk was transected to expose the left main coronary stem, which was opened beyond the obstruction and the incision extended through the left main coronary artery to the circumflex bifurcation and left anterior descending artery. A funnel-shaped coronary ostium was created with a glutaraldehyde-treated autologous pericardium onlay patch. Surgical reconstruction is a good alternative for left main coronary artery atresia with graft obstruction and preserves the remaining internal thoracic artery for future use.

Type
Brief Report
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Musiani, A, Cernigliaro, C, Sansa, M, Maselli, D, De Gasperis, C. Left main coronary artery atresia: literature review and therapeutical considerations. Eur J Cardiothorac Surg 1997; 11: 505514.CrossRefGoogle ScholarPubMed
Kitamura, S. Pediatric coronary artery bypass surgery for congenital heart disease. Ann Thorac Surg 2018; 106: 15701577.CrossRefGoogle ScholarPubMed
Raanani, E, Kogan, A, Shapira, Y, Sagie, A, Kornowsky, R, Vidne, BA. Surgical reconstruction of the left main coronary artery: fresh autologous pericardium or saphenous vein patch. Ann Thorac Surg 2004; 78: 16101613.CrossRefGoogle ScholarPubMed