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