Brak pnia lewej tętnicy wieńcowej a operacja korekcji wady zastawki aortalnej

Heart valve surgery demands cardiac arrest with concomitant cardiac protection against ischaemia and reperfusion. Anomalousorigin of left coronary artery (LCA) system require different approach to the infusion of cardioplegia into coronary ostia. Wepresent a case of a patient suffering from severe aortic stenosis with concomitant aortic insufficiency and double ostium LCAwith left artery descending and circumflex arteries originating separately from the left sinus of Valslava. During the procedurea retrograde, intermittent, cold — crystalloid cardioplegia was applied with moderate hypothermic arrest of 32°C. Antegradecardioplegia in patients presenting with anomalous origin of left coronary system when direct coronary intubation is requiredremains controversial. In such cases retrograde cardioplegia serves a valid option for the operating surgeon