Myers’ 3-sinus reconstruction for supravalvular aortic stenosis involving left coronary ostium: report of a case

Abstract

A 1-year-old boy with a bicuspid aortic valve, who had undergone successful repair of coarctation of the aorta by extended end-to-end direct anastomosis at the age of 1 month, was found to have mild supravalvular aortic stenosis involving the left coronary ostium. Because he was so young, we performed a modified Myers' all-autologous 3-sinus reconstruction to allow for potential growth. After transecting the ascending aorta just above the sinotubular junction, the superior wall of the left coronary ostium and the aortic root between both commissures were incised longitudinally, and then each of the incised parts was augmented by creating three flaps of distal aortic wall directly. Postoperatively, myocardial scintigram confirmed resolution of the pressure gradient at the supravalvular stenotic portion and improvement of the perfusion defect in the septal-anterior area.

Surgical strategies and outcomes of congenital supravalvular aortic stenosis

“…In our study, there was no need for coronary ostial augmentation or signs or symptoms suggestive of coronary artery obstruction. This may reflect the rarity of coronary ostial lesions in Asian patients with SVAS . Nevertheless, we continue to carefully inspect the coronary ostia for signs of obstruction during each repair.…”

“…This may reflect the rarity of coronary ostial lesions in Asian patients with SVAS. 6,[35][36][37] Nevertheless, we continue to carefully inspect the coronary ostia for signs of obstruction during each repair.…”

Isolated ostial left main coronary artery stenosis causing ischemic cardiomyopathy in a child with bicuspid aortic valve

“…Ostial stenosis of coronary arteries can develop as a result of certain congenital cardiac defects, namely, supravalvular aortic stenosis (SVAS); this is an important complication because it is a risk factor for sudden death in patients with SVAS. [ 2 3 ] However, coronary ostial stenosis associated with a BAV remains exceedingly rare. This case demonstrates that coronary ostial stenosis can occur in association with a BAV and should be considered in cases of ventricular dysfunction.…”