Surgical Pearls of the Transconal Unroofing Procedure-Modifications and Midterm Outcomes

Hani K Najm; Munir Ahmad; Miza Salim Hammoud; John P Costello; Tara Karamlou

doi:10.1016/j.athoracsur.2022.04.027

Surgical Pearls of the Transconal Unroofing Procedure-Modifications and Midterm Outcomes

Ann Thorac Surg. 2023 Jan;115(1):e29-e31. doi: 10.1016/j.athoracsur.2022.04.027. Epub 2022 Apr 28.

Authors

Hani K Najm¹, Munir Ahmad², Miza Salim Hammoud², John P Costello², Tara Karamlou²

Affiliations

¹ Department of Pediatric Cardiac Surgery and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic Children's Hospital, Cleveland, Ohio. Electronic address: najmh@ccf.org.
² Department of Pediatric Cardiac Surgery and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic Children's Hospital, Cleveland, Ohio.

PMID: 35490772
DOI: 10.1016/j.athoracsur.2022.04.027

Abstract

We have previously described our novel surgical technique in addressing the anomalous aortic origin of the left coronary artery with a transseptal course behind the right ventricular outflow tract. By means of the Najm procedure, we performed complete unroofing of the transseptal anomalous aortic origin of the left coronary artery and elongated the right ventricular outflow tract posteriorly using an autologous pericardial patch. This report documents modifications to address challenging anatomic variants and highlights the importance of managing septal arteries and myocardial bridges. We also describe the excellent midterm outcomes of 14 patients who have undergone the Najm procedure.

MeSH terms

Aorta / surgery
Cardiac Surgical Procedures* / methods
Coronary Vessel Anomalies* / surgery
Coronary Vessels
Humans
Myocardium