Luis E. Martínez-Bravo, MD, Carlos M. Mery, MD, MPH

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Presentation transcript:

Commentary: The intercoronary pillar—Not necessarily an innocent bystander Luis E. Martínez-Bravo, MD, Carlos M. Mery, MD, MPH The Journal of Thoracic and Cardiovascular Surgery Volume 158, Issue 1, Pages 218-219 (July 2019) DOI: 10.1016/j.jtcvs.2019.02.037 Copyright © 2019 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The intercoronary pillar, a thickening of the aortic wall extending from the intercoronary commissure cranially toward the sinotubular junction, can be quite thick in some patients (arrow). This pillar likely contributes to the aortic valve support and may play a role in the pathophysiology of anomalous aortic origin of a coronary artery. (©2014 Texas Children's Hospital, reprinted with permission.) The Journal of Thoracic and Cardiovascular Surgery 2019 158, 218-219DOI: (10.1016/j.jtcvs.2019.02.037) Copyright © 2019 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Effect of surgical unroofing of an anomalous coronary artery. A, Unroofing of a long intramural segment increases the size of the ostium, eliminates the intramural portion of the anomalous coronary, and places the ostium in the correct sinus, away from the intercoronary pillar. B, Unroofing of a short intramural segment increases the size of the ostium and eliminates the intramural portion of the coronary artery but may leave the coronary artery in close proximity to the intercoronary pillar and at risk for compression. An alternative surgical intervention, such as coronary translocation, may be preferred. RCA, Right coronary artery; PA, pulmonary artery; ALCA, anomalous left coronary artery. (©2016 Texas Children's Hospital, reprinted with permission.) The Journal of Thoracic and Cardiovascular Surgery 2019 158, 218-219DOI: (10.1016/j.jtcvs.2019.02.037) Copyright © 2019 The American Association for Thoracic Surgery Terms and Conditions

The intercoronary pillar can be quite thick in some patients. The Journal of Thoracic and Cardiovascular Surgery 2019 158, 218-219DOI: (10.1016/j.jtcvs.2019.02.037) Copyright © 2019 The American Association for Thoracic Surgery Terms and Conditions