title: Beating heart composite valve graft replacement and hemiarch aortic reconstruction in a patient with patent internal thoracic artery graft.
abstract: Effective myocardial protection is often challenging in patients who have undergone prior myocardial revascularization and require reintervention on the aortic root with patent grafts. We report the case of a patient who underwent composite valve graft replacement and hemiarch aortic reconstruction after repair of a ruptured aneurysm of the right coronary sinus of valsalva combined with a right internal thoracic artery to right coronary artery bypass grafting. Because the right coronary artery ostium was obstructed by the previously placed patch, we performed the redo operation on the beating heart using continuous patent graft flow and left coronary artery ostial perfusion.
authors.affiliation: Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, 2-39 Midorimachi, Fukuyama, Hiroshima 720-0804, Japan. hironobu12jp@yahoo.co.jp
authors.forename: Hironobu
authors.initials: H
authors.lastname: Morimoto
authors.forename: Toitsu
authors.initials: T
authors.lastname: Hirayama
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Misumi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Uesugi
mesh_terms: D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004108:Dilatation, Pathologic; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D008875:Middle Aged; D010477:Perfusion; D012086:Reoperation; D012850:Sinus of Valsalva / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency