PMC4857338_01
Preoperative coronary angiography shows that collaterals from the significantly dilated right coronary artery (RCA) feed the left coronary artery (LCA), in which flow is reversed, and the left coronary artery drains into the main pulmonary artery (PA).. Ao: aorta.
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Cardiac catheterization demonstrated a single, extraordinarily dilated right coronary artery arising from the aorta and retrograde filling of the similarly dilated left coronary system that produced opacification of the pulmonary trunk (Figure 1).
(a) The pulmonary trunk is transected, and the origin of the left coronary artery is detached from the pulmonary artery along with a sizable tissue flap from its posterior wall (*). (b) The excised pulmonary arterial wall flap is folded over with a single 7-0 polypropylene suture line laterally to produce a tube. (c) The extended coronary arterial conduit is anastomosed to the left lateral aspect of the ascending aorta (arrow). The resultant defect of the posterior aspect of the pulmonary artery is reconstructed using an e-PTFE patch (**).. Ao: aorta, PA: pulmonary artery, e-PTFE: expanded-polytetrafluoroethylene.
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Both side edges of the excised flap were sutured to each other with 7-0 monofilament suture to form an extension tube to lengthen the left coronary artery (Figure 2).
Postoperative multidetector computed tomography angiography shows that the reconstructed left coronary artery (LCA) is patent, and the new opening of the left coronary artery is in the anatomical position without any stenosis.. Ao: aorta; RCA: right coronary artery.
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Postoperative multidetector computed tomography angiography showed that the newly implanted left coronary artery was patent and anastomosed to the ascending aorta without stenosis (Figure 3).