Abstract
We performed an emergency root-commando procedure in a 41-year-old man with a dissecting aneurysm of the sinus of Valsalva and severe acute heart failure due to infective endocarditis, aortic regurgitation, and mitral regurgitation against a background of type 1 diabetes mellitus. The coronary artery was reconstructed using the Carrel patch method. The postoperative infection control was good, and computed tomography on postoperative day 13 showed no abnormalities. However, the patient complained of back pain on postoperative day 30, and computed tomography revealed a pseudoaneurysm of the left coronary artery. We decided to perform a reoperation. After resecting the tongue-shaped Valsalva graft around the left coronary artery button, the defect was patched with the bovine pericardium. The left coronary artery was reconstructed using a modified Cabrol technique. The post-reoperative course was good, and the patient was discharged home on day 17 after the reoperation. We experienced a case of left coronary artery button pseudoaneurysm in the subacute phase after an emergency root-commando procedure. Coronary artery button pseudoaneurysm is an important postoperative complication that requires detailed examination and re-operative planning. We report our experience and review the relevant literature.
