Unroofing Procedure for Correction of an Anomalous Right Coronary Artery From the Left Aortic Sinus

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By Alexander Kadner, MD, Florian Schoenhoff, MD and Thierry Carrel, MD

Anomalous right coronary artery arising from the left aortic sinus is known to be associated with an increased risk of sudden death. Surgery is recommended for all adult patients who are symptomatic or who have evidence of exercise-induced myocardial ischemia. Several surgical techniques have been described to address this defect, such as coronary artery bypass grafting or reimplantion of the ostium into the right sinus of Valsalva.

The currently favored approach for repair is the anatomic correction by an unroofing procedure, that results in relocation of the coronary artery into the appropriate aortic sinus and is demonstrated in the following video. This approach can be carried out with minimal risk, good anatomical and functional results.