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

Jung HJ 1 , Kwon WK 2 , Lee SJ 3 , Mohamed N 4 , Shin BM 5 , Lee J 6 Show all authors , Kim TY 7

Affiliations 

  • 1 Department of Anesthesiology, Uijeongbu St. Mary Hospital, The Catholic University of Korea, Uijeongbu, Gyounggi-do, Korea
  • 2 Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Korea
  • 3 Department of Chest Surgery, Konkuk University Medical Center, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Korea
  • 4 Cardiothoracic Anesthesiology and Perfusion Unit, Hospital Tengku Ampuan Afzan, 25100, Jalan Tanah Putih, Kuantan, Pahang, Malaysia
  • 5 Department of Anesthesiology, Konkuk University Medical Center, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Korea
  • 6 Department of Business, Sungkyunkwan University, 25-2 Sungkyunkwan-ro Jongro-gu, Seoul, Korea
  • 7 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
BMC Anesthesiol, 2016 10 04;16(1):83.
PMID: 27716083

Abstract

BACKGROUND: 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.

CASE PRESENTATION: 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.

CONCLUSION: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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