Coronary Artery Reconstruction Using a Bioengineered Patch and Epicardial Tunnel.

An infant girl presented within a month after undergoing repair of the anomalous left coronary artery (LCA) from pulmonary artery by reimplantation technique with long-segment LCA occlusion and no flow to the bifurcation. She was severely symptomatic and referred for cardiac transplant evaluation. CorMatrix small-intestinal submucosa-extracellular matrix (CorMatrix Cardiovascular, Roswell, GA) was selected for the construction of LCA by creation of an epicardial tunnel to the LCA bifurcation. At 18 months after the operation, the patient was asymptomatic with normal growth and development, an unobstructed LCA system, and normal left ventricular size and function. With myocardial remodeling, this child has normal systolic function and has avoided cardiac transplantation.