Work

Retrograde Percutaneous Re-Anastomosis of Occluded Right Coronary Artery Through a Synthetic Bentall Graft

Year: 2026

Type: article

Abstract: BACKGROUND: In some Bentall surgeries, a coronary artery is not reimplanted but instead grafted. CASE SUMMARY: A 49-year-old patient who underwent prior Bentall surgery using a synthetic root, mechanical valve, and saphenous vein graft (SVG) to the right coronary artery (RCA) developed non-ST-segment elevation myocardial infarction due to graft failure. We performed retrograde recanalization of the native RCA and created a neo-ostium through the graft using electrosurgery, high-pressure and molding balloons, and stenting without complications. DISCUSSION: Success was achieved through careful planning using coronary computed tomography angiography and execution using latest available techniques and technology. NOVELTY: This is the first reported percutaneous re-anastomosis of a coronary to a synthetic aortic graft. TAKE-HOME MESSAGE: Failure of an SVG attached to a non-reimplanted coronary post Bentall is a challenging clinical situation. We could re-anastomose the RCA to the synthetic Bentall graft using retrograde, electrosurgery, novel balloon techniques, and stenting.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106715

Authors: Stéphane Rinfret, Moghniuddin Mohammed, Glen A. Henry

Institution: Northeast Georgia Medical Center

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850