Unroofing of Left Coronary Artery in a Patient with Aortic Valve Replacement

Abstract

During aortic valve replacement, coronary artery obstruction is a rare but fatal complication. It may require revision of the surgical procedure including re-implantation of the valve or additional coronary revascularization. It is more common in the presence of abnormality of coronary artery like malposition or abnormal course. We report a case of 32 years old gentleman undergoing aortic valve replacement for severe aortic stenosis, having an abnormally placed left main coronary artery ostium. The risk of coronary ostial compression on seating the prosthetic valve was evident. A left main coronary artery unroofing was performed to translocate the ostium to avoid the obstruction. The patient recovered well intra and postoperatively and is doing well at nine months follow up.