Modified aortic root remodeling for annuloaortic ectasia with abnormal coronary take-off

The abnormality of coronary arterial take-off is a limiting factor for a successful aortic valve sparing procedure. We present a 13-year-old boy, with Marfan syndrome and annuloaortic ectasia, whose coronary take-off was found to be abnormal during surgery. Two adjacent coronary orifices were located in the left coronary sinus and very close to the right–left commissure. A modified aortic remodeling procedure was successfully performed without translocation of the coronary artery.