Stentless aortic root bioprosthesis implantation and coronary artery bypass grafting in a patient with single right coronary artery.

Coronary arteries with anomalous origin from the aorta can be a risk factor during aortic root procedures. We report on the successful management of aortic root surgery in a 76-year-old man with a single coronary ostium. Preoperative computed tomography and angiography revealed an anomalous course of the left main coronary artery from the right sinus of Valsalva. A stentless aortic root bioprosthesis (Prima Plus) was implanted using a modified subcoronary technique. The origin of the left main coronary artery was approximately 2 mm beyond the ostium of the common trunk. Attention to the anatomic relationship of the anomalous coronary arteries to the aorta by clarifying the anatomy of coronary arteries in advance allowed us to safely perform aortic root surgery in a patient with an anomalous origin of the coronary arteries.