Surgical strategies for anomalous origin of the left coronary artery from the right pulmonary artery with an intramural aortic course: A report of 10.

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Presentation transcript:

Surgical strategies for anomalous origin of the left coronary artery from the right pulmonary artery with an intramural aortic course: A report of 10 cases Hui Zhang, MD, Pei Cheng, MD, Ge Jin, MD, Ding Han, MD, Yi Luo, MD, Jia Li, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 153, Issue 3, Pages 648-653 (March 2017) DOI: 10.1016/j.jtcvs.2016.10.063 Copyright © 2016 Terms and Conditions

Figure 1 A, Anatomy of the anomalous origin of the LCA from the bifurcation of the right and MPA with the intramural aortic segment. B, Operative illustration of the button transfer showing a horizontal incision made at the left side of the ascending aorta at the same level of the LCA orifice with the collar of the button around the LCA orifice, which is detached and switched anteriorly. C, Operative illustration of anastomosis of the button to the aorta incision. LCA, Left coronary artery; Ao, aorta; MPA, main pulmonary artery; RPA, right pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 648-653DOI: (10.1016/j.jtcvs.2016.10.063) Copyright © 2016 Terms and Conditions

Figure 2 A, Anatomy of the anomalous origin of the LCA from the RPA more distal to the bifurcation with the intramural aortic segment. B, Operative illustrations showing that the short bridging portion of the LCA and the aortic intima of the intramural segment were incised. C, Operative illustrations of anastomosis of the button to the aorta incision. LCA, Left coronary artery; Ao, aorta; MPA, main pulmonary artery; RPA, right pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 648-653DOI: (10.1016/j.jtcvs.2016.10.063) Copyright © 2016 Terms and Conditions

Figure 3 Two computed tomograms of apical view (A) and lateral view (B) showing the large LV aneurysm of 50 × 60 mm2 in Patient No. 5. LV, Left ventricular. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 648-653DOI: (10.1016/j.jtcvs.2016.10.063) Copyright © 2016 Terms and Conditions

Operative illustrations of the button transfer and unroofing of intramural segment. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 648-653DOI: (10.1016/j.jtcvs.2016.10.063) Copyright © 2016 Terms and Conditions