Myers' 3-sinus reconstruction for supravalvular aortic stenosis involving left coronary ostium: report of a case

A 1-year-old boy with a bicuspid aortic valve, who had undergone successful repair of coarctation of the aorta by extended end-to-end direct anastomosis at the age of 1 month, was found to have mild supravalvular aortic stenosis involving the left coronary ostium. Because he was so young, we performed a modified Myers' all-autologous 3-sinus reconstruction to allow for potential growth. After transecting the ascending aorta just above the sinotubular junction, the superior wall of the left coronary ostium and the aortic root between both commissures were incised longitudinally, and then each of the incised parts was augmented by creating three flaps of distal aortic wall directly. Postoperatively, myocardial scintigram confirmed resolution of the pressure gradient at the supravalvular stenotic portion and improvement of the perfusion defect in the septal-anterior area.