Anomaly Of Right Coronary Artery Research Articles

Surgical management and long-term follow-up of aberrant right coronary arteries in adults.

Anomalous origins of the right coronary artery (RCA) can cause ischaemia and sudden cardiac death, particularly if the RCA runs between the aorta and pulmonary artery. Conventional coronary artery bypass grafting (CABG) can be affected by early graft failure due to collateral blood flow. We present our institutional experience in managing patients with RCA anomalies. A single-center retrospective review of all patients who underwent surgery for aberrant right coronary arteries between 2005 and 2021 was conducted and in-hospital and long-term outcomes were analysed at our institution. A total of 10 patients (5 females, median age: 51 years, 36-62) were identified. They presented with symptoms of chest pain (n = 8), dyspnoea (n = 1) or following cardiac arrest (n = 1). In the majority the RCA originated from the left coronary sinus (n = 9). In one of those patients and one in whom the RCA originated directly from the left anterior descending artery CABG was performed. The other 8 patients were treated using transfer of the RCA ostium. All patients were discharged home (median hospital stay 5 days, range: 4-10). Four patients experienced post-op atrial fibrillation. No other complications were observed. At a median follow-up of 10 years and 9 months, 9 patients were alive and free from cardiac symptoms. One patient died 3 years postsurgery due to liver failure, unrelated to cardiac disease. In patients with an aberrant RCA, transfer of the ostium into the RCS carries a low surgical risk. It overcomes early graft failure in these patients, who present with a dynamic impairment in RCA blood flow. However, if fixed proximal RCA flow-limiting pathology exists, conventional bypass surgery is feasible.

Rare case of anomalous right coronary artery from pulmonary artery (ARCAPA syndrome)

Anomalous right coronary artery from pulmonary artery (ARCAPA) is a rare congenital anomaly of right coronary artery, most of the patient are asymptomatic, although myocardial infarction and sudden cardiac arrest has been reported. Herein we present a 5 month old infant presented with chest infection, during routine examination cardiac murmur detected, anomalous right coronary artery from pulmonary artery suspected by transthoracic Echocardiography which showed dilated (4mm) left main stem of coronary artery with mild left ventricular dilatation, but the origin of right coronary artery couldn’t be detected. Coronary angiography done which confirm the diagnosis and the child successfully operated on for reimplantation of right coronary artery to the aortic cusp.

Acut Myocardial Infarction in Patient with Anomaly of Right Coronary Artery Originating from Left Circumflex Artery: A Case Report

Sag koroner arterin, Sol sirkumflex arterin (LCX) distalinden cikmasi nadir gorulen bir anomalidir. Ani olum gibi tehlikeli klinik durumlara yol acabildiginden taninmasi onemlidir. Bu yazida, sol sirkumflex arterden koken alan sag koroner arter anomalisi olan 52 yasinda erkek hastada gelisen akut inferoposterior sag miyokardial infarktus olgusu sunduk.

Clinical analysis of right coronary artery anomalies in 8 children

Objective To observe the clinical characteristics and improve the diagnosis and treatment of right coronary artery anomalies in children. Methods The clinical characteristics, laboratory examination, treatment and prognosis were retrospectively analyzed in children with right coronary artery anomalies (complex cardiac anomalies was excluded), who were admitted into Beijing Children′s Hospital Affiliated to Capital Medical University from January 2009 to December 2014. Results A total of 8 medical records of children with right coronary artery anomalies, among whom 5 cases were male and 3 cases were female, with a mean age of (7.06±1.37) years old.In these 8 patients, there were 5 patients with right coronary artery originating from left coronary sinus, 1 patient with right coronary artery originating from left wall of aorta, 1 patient with single left coronary artery type Lipton L Ⅱ, and 1 patient with right coronary artery absence.The main symptoms included chest distress, chest pain and palpitation in elder children, but in infants, the primary symptom was poor feeding.One case of these patients represented syncope.Electrocardiogram of these patients showed ST-T wave changes, sinoatrial block, and sinus arrest.Ultrasonic cardiogram failed to discover the co-ronary artery anomalies.Four cases showed enlarged left ventricular end-diastolic diameter, and 1 case showed slight decrease of left ventricular ejection function.All 8 patients were given myocardial tonic with limitation in doing exercise, and clinical follow-up studies were conducted for 6 months.Four patients with enlarged left ventricular were treated with Captopril, and 3 patients of them recovered after 3 to 6 months.Two patients with sinus node malfunction were treated with permanent pacemaker implantation in other hospitals. Conclusions Right coronary artery anomaly in children is rare.Patients with cardiac ischemia and sinus node malfunction should be aware of right coronary malformation.64-section multidetector computerized tomography angiography can diagnose right coronary artery anomalies.To patients with right coronary artery anomalies, vigorous exercises should be avoided to decrease adverse cardiac events. Key words: Coronary artery anomalies; Sinoatrial block; Sinus arrest; Child

Unreported Coronary Artery Anomaly: Association of Right Coronary Artery and Circumflex Coronary Artery with Single Ostium Originate from High Left Anterior Aorta

A 55-year-old female patient was admitted with chest pain for 8 hours. She has no risk factors for coronary artery disease. There were no significant pathological findings on physical examination. ST-segment elevation in lead V 1-6 were observed on electrocardiogram. Coronary angiography revealed the left anterior descending artery originating from the left sinus valsalva alone and coursing normally. It was totally occluded after diagonal branch (Fig. 1A). Percutaneous transluminal coronary angioplasty and stenting were performed successfully (Fig. 1B). By a left Amplatz catheter, a coronary ostium, was cannuled at the left anterior surface of the ascending aorta, 2-3 cm above the sinotubuler junction. It was divided into two branches, as circumflex coronary artery (Cx) and right coronary artery (RCA), after intercrossing the front side of the aorta (Fig. 2). There were non-critical lesions in RCA and non-critical and critical lesions in the mid and distal part of Cx (Fig. 2B). Fig. 1 Fig. 2 The incidence of coronary anomaly in the large case series is about % 1,3.1) In Yamanaka's classification1) only the left main coronary artery and RCA anomalies has been listed as coronary anomalies originate from the aorta. We didn't find any reported coronary anomaly case, similar to our case in the literature.2),3) We report an association of RCA and Cx with single ostium originate from high left anterior aorta case. This case may find a different place in the classification of coronary anomalies originating from the ascending aorta.

Successful Percutaneous Coronary Intervention in an Anomalous Origin of the Right Coronary Artery From the Ascending Aorta Above the Left Sinus of the Valsalva

The anomalous origin of the right coronary artery (RCA) is a rare condition. Most RCA anomalies are usually found incidentally, but these findings have clinical significance because many patients, particularly young ones, present with sudden death, myocardial ischemia and syncope without other symptoms. We describe a case of a 39-year-old male patient that presented with effort chest pain and was diagnosed with anomalous RCA that originated from the ascending aorta with prior history of repairing ruptured sinus valsalva and ventricular septal defect. The anomalous origin of RCA was identified by multidetector computed tomography (MDCT). Successful percutaneous coronary intervention was performed guided by MDCT coronary images and intravascular ultrasound.

Single left coronary artery with separate origins of proximal and distal right coronary arteries from left anterior descending and circumflex arteries – a previously undescribed coronary circulation

A single left coronary artery with right coronary artery arising from either left main stem (LMS) or left anterior descending artery (LAD) or circumflex artery (Cx) is an extremely rare coronary anomaly. This is the first report of separate origins of proximal and distal RCA from LAD and circumflex arteries respectively in a patient with a single left coronary artery. This 57 year old patient presented with unstable angina and severe stenotic disease of LAD and Cx arteries and underwent urgent successful quadruple coronary artery bypass grafting. The anomalies of right coronary artery in terms of their origin, number and distribution are reviewed.

Anomalous Origin of the Right Coronary Artery from the Diagonal Branch of the Left Anterior Descending Coronary Artery

Anomalous origin of the right coronary artery (RCA) is uncommon in patients undergoing cardiac catheterization. Most RCA anomalies are usually found incidentally. However, some anomalies may be associated with malignant courses such as myocardial ischemia, syncope or sudden cardiac death. We present a previously unreported case of a 55-year-old female who had anomalous RCA arising from the diagonal branch of LAD, a variant of L-II Lipton classification, which caused chest pain. (Korean Circulation J 2004;34(6):615-617) KEY WORD:Coronary vessel anomalies.