A Case Report of Modified Cabrol Technique in a 60-Year-Old Male with Coronary Origin Anatomical Variant

• Published in: Chirurgia (Bucharest, Romania : 1990) Vol. 119; no. 4; p. 445
• Main Authors: Moldovan, Horaţiu, Safta, Maria Sabina, Mirea, Liliana, Badea, Aida, Nechifor, Elena, Guţă, Andrada, Dorobanţu, Lucian, Voica, Cristian, Robu, Mircea, Gheorghiţă, Daniela, Crăciun, Mihaela, Zăman, Alexandru, Ciomag, Raluca
• Format: Journal Article
• Language: English
• Published: Romania 01-08-2024
• Subjects: Aortic Aneurysm - complications; Aortic Aneurysm - surgery; Aortic Valve - abnormalities; Aortic Valve - surgery; Aortic Valve Disease - complications; Aortic Valve Disease - surgery; Aortic Valve Stenosis - surgery; Bicuspid Aortic Valve Disease - complications; Bicuspid Aortic Valve Disease - surgery; Blood Vessel Prosthesis Implantation - methods; Coronary Stenosis - complications; Coronary Stenosis - etiology; Coronary Stenosis - surgery; Coronary Vessel Anomalies - complications; Coronary Vessel Anomalies - surgery; Heart Valve Diseases - complications; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation - methods; Humans; Male; Middle Aged; Replantation - methods; Treatment Outcome; aneurysm; Cabrol; aorticrootreplacement; coronaryostiaanatomicalvariant; bicuspidaorticvalve; dissection
• ISSN: 1221-9118
• DOI: 10.21614/chirurgia.2967

Reconstruction surgery of the proximal aorta in most cases involves the use of an aortic conduit, followed by reimplantation of the coronary ostia. Although uncommon, the origin of the coronary arteries in certain anatomical variants poses additional difficulties when performing surgery on the aortic root and requires a different treatment rationale. Case report: We hereby present the case of a 60-year-old patient with multiple cardiovascular risk factors (smoking, arterial hypertension and dyslipidemia), suffering from severe degenerative stenosis of a bicuspid aortic valve, associated with ascending aorta aneurysm and a significant extrinsic stenosis of the left coronary artery caused by the aneurysm. The patient presented with severe degenerative bicuspid aortic valve stenosis associated with ascending aorta aneurysm and a significant extrinsic stenosis of the left coronary artery caused by the aneurysm. Following the preoperative assessment, it was decided that the best course of action was to perform surgery on the aortic valve and ascending aorta. During the surgery, the origin of the right and left coronary ostia were found at the level of the left coronary cusp, both forming a common coronary button. Due to this particular anatomical variant, it was decided to reimplant them as a common button onto the main conduit by means of an interposed No.10 PTFE (Polytetrafluoroethylene) vascular prosthesis. Conclusion: A rare case of aortic root surgery associated with coronary ostia origin variant "shotgun barrel", which required a different method of reimplantation: modified Cabrol technique.