Repair techniques for anomalous aortic origins of the coronary arteries

Cardiol Young. 2015 Dec;25(8):1546-60. doi: 10.1017/S1047951115002048.


Anomalous aortic origins of the coronary arteries comprise approximately one-third of all coronary artery anomalies and are characterised by coronary arteries with anomalies of aortic origin involving abnormal courses, stenoses, and compression that can lead to myocardial ischaemia and sudden death. Operative techniques to treat these anomalies have not been standardised yet. Moreover, the management of potential complications has not been addressed. Common and rare forms of anomalous aortic origins of the coronary arteries are reviewed and understood standard techniques for an uncomplicated unroofing procedure are illustrated. Also noted are techniques that can be applied to unexpected anatomical findings and unwanted complications that could prove to be life-threatening. Several technical recommendations are offered.

Keywords: Myocardial ischaemia; stenosis; sudden death; unroofing.

Publication types

  • Review

MeSH terms

  • Aorta, Thoracic / abnormalities*
  • Aorta, Thoracic / surgery*
  • Cardiac Surgical Procedures / methods*
  • Coronary Vessel Anomalies / surgery*
  • Humans
  • Postoperative Complications
  • Sinus of Valsalva / abnormalities
  • Sinus of Valsalva / surgery*