# Creation of Coronary Conduit and Neo-Ostium in Previously Ligated Left Coronary Artery With Aortic Homograft

## TL;DR

A 69-year-old man with a complex heart condition underwent a novel procedure to reconnect a surgically disrupted coronary artery using chronic total occlusion techniques.

## Contribution

The paper presents a novel application of chronic total occlusion techniques to reconnect a surgically disrupted coronary artery.

## Key findings

- Retrograde chronic total occlusion percutaneous coronary intervention techniques were successfully used to reconnect a disrupted artery with the aortic root.
- Electrocautery-assisted reentry facilitated the procedure in a patient with graft failure and severe native vessel disease.

## Abstract

A 69-year-old man with a complex cardiac history including prosthetic aortic valve endocarditis with abscess involving the left coronary artery requiring placement of an aortic root homograft with coronary bypass grafting and ligation of the left coronary presented with severe angina following graft failure with severe native vessel disease. Retrograde chronic total occlusion percutaneous coronary intervention techniques, including electrocautery-assisted reentry, were used to connect the disrupted artery with the aortic root.

Chronic total occlusion percutaneous coronary intervention techniques may facilitate reconnection of surgically disrupted coronary arteries with the aortic root.