title: Intraoperative echocardiographic delineation of the high take-off coronary ostia during an extensive surgical repair of the bicuspid aortic valve and dilated sinotubular junction: a case report.
abstract: This study reports the efficacy of intraoperative transesophageal echocardiography (TEE) for evaluation of high take-off coronary ostia and proximal coronary arterial flows as an alternative to preoperative coronary angiography.
  
  
  
  In a 65-year old male undergoing the bicuspid aortic valve (BAV) repair and the extensive remodeling of dilated sinus and tubular junction, and preoperative coronary angiography were unsuccessfully completed due to an allergic reaction to the contrast medium. Intraoperative TEE by employing various 3-dimensional volume images of coronary ostia and Doppler tracings of the coronary arterial flows enabled a thorough pre-procedural evaluation of the high take-off coronary arteries and post-procedural evaluation by confirming the absence of any compromise in coronary arterial flow.
  
  
  
  In the present case, intraoperative application of various TEE imaging modalities enabled comprehensive evaluation of high-taking off coronary artery, as an alternative to preoperative coronary angiography, in a patient undergoing an extensive aortic valve and aortic root repair procedure.
authors.affiliation: Department of Anesthesiology, Uijeongbu St. Mary Hospital, The Catholic University of Korea, Uijeongbu, Gyounggi-do, Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Korea.
authors.forename: Won-Kyoung
authors.initials: WK
authors.lastname: Kwon
authors.affiliation: Department of Chest Surgery, Konkuk University Medical Center, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Korea.
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Cardiothoracic Anesthesiology and Perfusion Unit, Hospital Tengku Ampuan Afzan, 25100, Jalan Tanah Putih, Kuantan, Pahang, Malaysia.
authors.forename: Nazri
authors.initials: N
authors.lastname: Mohamed
authors.affiliation: Department of Anesthesiology, Konkuk University Medical Center, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Korea.
authors.forename: Bo-Mi
authors.initials: BM
authors.lastname: Shin
authors.affiliation: Department of Business, Sungkyunkwan University, 25-2 Sungkyunkwan-ro Jongro-gu, Seoul, Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 143-729, Republic of Korea. taeyop@gmail.com.
authors.forename: Tae-Yop
authors.initials: TY
authors.lastname: Kim
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D017023:Coronary Angiography / Q000379:methods; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D018618:Echocardiography, Doppler, Color / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods
keywords: Aortic valve repair; Coronary artery; Coronary ostia; Transesophageal echocardiography