[A case report of bentall type operation for annuloaortic ectasia with anomalous origin of the right coronary artery complicated by aortic dissection]

Abstract

A 49-year-old woman of Marfan's syndrome, who had undergone replacement of the thoracoabdominal aorta for Stanford B type aortic dissection at 47 years of age, developed Stanford A type aortic dissection with annulo-aortic ectasia and aortic regurgitation. At the time of operation, anomalous origin of the right coronary artery from the left sinus of Valsalva and near site of the left coronary orifice were found. Then, composite graft replacement of the ascending aorta and aortic valve, in which a single graft of 16 mm in diameter was interposed between the coronary ostia and composite graft, was performed. Anomalous origin of the right coronary artery from the left sinus of Valsalva is a rare congenital abnormality. It is a matter how to reconstruct the coronary circulation for this type of operation. This technique was useful to reconstruct the aortic root even when an anomalous origin of the coronary artery existed.