Figure Legends
Figure 1 : If the observer stands in the non-adjacent sinus of the aortic root, and looks towards the pulmonary root (Panel A), one of the sinuses of the aortic root is to the right hand of the observer (#1), whilst the other is to the left hand (#2). The system retains its ability to distinguish between the sinuses being right handed and left handed irrespective of the relationship between the arterial trunks (Panel B).
Figure 2 : The commonest variant is for the right coronary artery to arise from the left-handed sinus, and the main stem of the left coronary artery from the right-handed sinus (Panel A). In the second most common pattern, the retropulmonary circumflex artery also arises from sinus #2. The main stem of the left coronary artery can arise from sinus #2 (Panel C), with the antero-aortic right coronary artery arising from sinus #1. All coronary arteries can arise either from sinus #1 (Panel E) or from sinus #2 (Panel F). Panels A and F also show commissural mismatch (white arrows with red borders).
Figure 3 : Panel A shows the sinus #2 in a heart in which the main stem of the left coronary artery is intramural. An intramural anterior interventricular artery originating from sinus #2 is shown in panel B, with a retropulmonary circumflex artery also arising from this sinus.
Figure 4 : The steps, I and II, showing coronary reimplantation after neoaortic reconstruction in panel A. Panel B showing transfer to medially hinged trapdoors with panel C showing the technique of for transfer of the retropulmonary circumflex artery. Panel D shows steps I and II for transfer of a single coronary artery.
Figure 5 : In Panel A, steps I and II show a technique of relocation of a single coronary artery. In Panel B, the two steps are shown for the “bay window” transfer. Panel C shows the two steps of the aortic sinus pouch technique for transfer of an intramural coronary artery.
Figure 6 : In Panel A, steps I through IV illustrate the two-button technique for transfer of intramural coronary arteries. Steps I through III in Panel B show the modification of the initial creation of an aortopulmonary window.
Figure 7 : In Panel A, steps I through III show the initial technique proposed for anatomical correction without arterial translocation.41 Steps I and II in panel B show the modification using a bovine pericardial patch,42 while steps I and II in panel C show the modification using a D-shaped hinged aortic cuff from the aortic non-adjacent sinus.43
Figure 8 : Panel A shows steps I and II of in-situ relocation using hockey-stick incisions.44 Panel B shows steps I and II of the augmentation of the button using a pericardial hood.46 Panel C shows steps I and II of the technique using a pulmonary arterial patch.47