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connector seemed very effective, especially in terms of the control of bleeding from the friable apex. It enabled us to take deep bites through the epicardium and the endocardium, allowing excellent integrity between the left ventricle and the graft. In the present case bleeding from the proximal anastomosis was not a problem at all. This technique has additional merits. Crossclamping of the aorta is never required. It does not compromise major coronary arteries, other valves, or the conduction system. Paravalvular leak and patient-prosthesis mismatch are completely avoided. Apicoaortic conduit for patients after CABG with acquired aortic stenosis is feasible but requires special attention, especially when coring the ventricle. With more modifications, this method has the possibility for a more common use. References 1. Cooley DA, Lopez RM, Absi TS. Apicoaortic conduit for left ventricular outflow tract obstruction: revisited. Ann Thorac Surg. 2000;69: 1511-4. 2. Lockowandt U. Apicoaortic valved conduit: potential for progress? J Thorac Cardiovasc Surg. 2006;132:796-801. 3. Gammie JS, Brown JW, Brown JM, Poston RS, Pierson RN III, Odonkor PN, et al. Aortic valve bypass for the high-risk patient with aortic stenosis. Ann Thorac Surg. 2006;81:1605-11. 4. White CS, Jeudy J, Read K, Brown JM, Griffith BP, Gammie JS. Aortic valve bypass for aortic stenosis: imaging appearances on multidetector CT. Int J Cardiovasc Imaging. 2006. Epub ahead of print. 5. Yamaura Y, Yoshikawa J, Yoshida K, Akasaka T. Echocardiographic findings of subepicardial aneurysm of the left ventricle. Am Heart J. 1994;127:211-4.

Arterial coronary–coronary conduit over single, distal left anterior descending coronary artery lesion: 3.5 years afterward