Complex coronary arteries with anterior and/or
retro-pulmonary looping
The medial trapdoor technique: A medially hinged neoaortic
trapdoor is useful in cases of significant
looping.33,39 With anterior looping, the coronary
button can be positioned at or above the neoaortic
anastomosis.33,35
Yacoub technique: This technique is used to relocate the right
coronary artery associated with retropulmonary looping of the
circumflex artery (Figure 4C).4