# Valve-Sparing Root Replacement With Anomalous Left Circumflex From the Right Coronary Sinus

## TL;DR

This paper describes a surgical technique for valve-sparing root replacement in a patient with a rare coronary artery anomaly.

## Contribution

The paper presents a novel surgical approach for VSRR in the presence of an anomalous left circumflex artery.

## Key findings

- VSRR can be successfully performed in patients with an anomalous left circumflex artery.
- The described technique allows for safe reimplantation despite the unusual coronary anatomy.

## Abstract

Valve-sparing root replacement (VSRR) with the reimplantation technique is ideal for most cases of isolated aortic root aneurysm with a well-functioning valve. VSRR is also increasingly applied across a broader spectrum of root pathology with otherwise sparable aortic valves. Recently, there is increased recognition of coronary artery anomalies, which present unique challenges at the time of VSRR. We present a case description and video of our technique for VSRR in a patient with an anomalous left circumflex from the right coronary sinus, with a separate ostium, and retroaortic course.