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

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.