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Nikola Dobrilovic, MD, Jaishankar Raman, MD, PhD, James G

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1 Long-Term Outcomes of External Repair as a Rescue Operation for Atrioventricular Groove Disruption 
Nikola Dobrilovic, MD, Jaishankar Raman, MD, PhD, James G. Fingleton, MD, Andrew Maslow, MD, Arun K. Singh, MD  The Annals of Thoracic Surgery  Volume 103, Issue 2, Pages (February 2017) DOI: /j.athoracsur Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Operative technique. (A) Atrioventricular groove (AVG) disruption (AVGD) identified. Note that the exact location and extent of the defect are usually unclear and the circumflex (Cx) coronary artery system is in proximity. (LAD = left anterior descending artery.) (B) Obtuse marginal coronary artery bypass grafting should be considered before initiation of the AVGD repair. Large horizontal mattress sutures are applied to a generous region of the AVG to ensure adequate containment. Felt strips (shown), large felt pledgets, and/or adjacent left atrial appendage are usually incorporated into the repair. (C) Completed repair with coronary artery bypass with saphenous vein graft (SVG) protecting the circumflex (Cx) coronary system. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 An axial plane computed tomography image demonstrates a chronic pseudoaneurysm that occurred after a previous external repair of atrioventricular groove disruption. The circle identifies the opening of the pseudoaneurysm, and the arrow identifies a mechanical prosthetic valve. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

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