Anomalous Origin and Course of the Right Coronary Artery (original) (raw)
Related papers
The Annals of Thoracic Surgery, 2020
Aberrant origin of the coronary artery from the opposite sinus of Valsalva is a rare congenital coronary anomaly associated with increased risk of myocardial ischemia and sudden death in young patients. We report a case of resuscitated sudden cardiac death in a patient with an anomalous origin of the right coronary artery, arising from the left sinus of Valsalva and coursing between the ascending aorta and the pulmonary artery. Successfully coronary arterial bypass grafting using the left radial artery was performed. Despite the risk of fatal issue, surgical management of patient with this coronary anomaly still remains controversial.
Journal of Pediatric Intensive Care, 2015
A 14-year-old female was brought to the emergency room with chest pain, shortness of breath and cyanosis. She was previously well with the exception of one previous post-exertion seizure-like event. On this day, she had been jogging when she complained of chest pain and collapsed. Her initial vital signs were heart rate 58/min, blood pressure 70/40 mmHg, respiratory rate 50/min, temperature 37°C, and SaO2 68%. Electrocardiogram showed significant ST changes. She received multiple fluid boluses and dopamine was initiated (5-20 μg/kg/min). She was intubated and started on norepinephrine (0.05-0.5 μg/kg/min) for refractory hypotension. During the resuscitation, echocardiography showed poor left ventricular function with an ejection fraction of 38%. The coronary arteries could not be visualized clearly. To maintain cardiac output, epinephrine by infusion (0.1-3.0 μg/kg/min) was added, and she received multiple epinephrine boluses. Despite maximum ventilatory support and escalating inotropes, cardiac output rapidly deteriorated, and she developed an agonal rhythm with non-reactive pupils. Resuscitation was discontinued. Autopsy demonstrated an anomalous origin of left coronary artery from the right aortic sinus of Valsalva with acute myocardial ischemia. We describe the sudden coronary death of a young patient, and we review congenital coronary artery pathophysiology, screening difficulties and potential interventions.
Anomalous Origin of Left Coronary Artery – an unusual case
2018
Anomalies of the coronary arteries are rare but are an important cause of sudden cardiac arrest in young athletes. Sudden cardiac arrest has been reported in patients with congenital anomalies of the coronary arteries. We present a rare case of sudden cardiac arrest caused by anomalous left main coronary artery originating high from the posterior aspect of left sinus of Valsalva with intramural retroaortic segment, associated with bicuspid aortic valve.
High Risk Features of an Anomalous Origin of the Right Coronary Artery
2021
Anomalous aortic origin of the coronary arteries (AAOCA) is a rare congenital abnormality. It is usually asymptomatic and often found incidentally during coronary angiography. However, it can also be discovered during the autopsy of young healthy adults who have suffered from sudden cardiac death (SCD). AAOCA represents the second most common cause of SCD in young athletes. Herein, we report a case of a 39-year-old patient with left-sided right coronary anomaly with multiple high-risk features who presented with life-threatening symptoms for SCD but normal electrocardiography, echocardiography, and cardiac markers. The coronary computed tomography revealed an anomalous coronary artery from the left sinus of Valsalva with a hypoplasic origin and a high-risk path between the aorta and the pulmonary artery with a short intramural path. He was surgically managed with a coronary artery bypass with an uneventful follow-up.
Anomalous Origin of Left Main Coronary Artery from the Right Sinus of Valsalva
Anomalous coronary arteries are rare congenital variations with cases ranging from asymptomatic to life-threatening. Given the wide variability of coronary anomalies, it is challenging to predict their clinical consequences. Here, we present the ‘malignant’ variant – interarterial course of the left coronary artery between the aorta and pulmonary trunk – given the highest risk of sudden cardiac death among the various coronary anomalies. Learning Objectives: 1. To describe the ‘malignant’ interarterial course of the left coronary artery and its association with sudden cardiac death 2. To present the various surgical options recommended to patients with this variant
Aborted sudden cardiac death associated with an anomalous right coronary artery
BMJ case reports, 2015
Coronary artery anomalies arising from the opposite sinus of Valsalva and having an interarterial course between the aorta (AO) and pulmonary artery (PA) are the second most common cause of sudden cardiac death among young athletes, after hypertrophic cardiomyopathy. The right coronary artery (RCA) originating from the AO above the left sinus of Valsalva (LSV) is an extremely rare anomaly. We report the first case of a RCA arising from the AO above the LSV that subsequently runs between the AO and the PA, discovered by a 64-slice multidetector coronary CT, in a patient who was successfully resuscitated from ventricular fibrillation (VF) cardiac arrest while running in a marathon race.
A Rare Case of an Anomalous Origin of the Right Coronary Artery: A Case Report
2019
The anomalous origin and pathway of the right coronary artery (RCA) is a very rare congenital anomaly of the coronary arteries, in which may be dangerous, and even fatal if it is not discovered. In our case, the patient was presented as an acute MI, and according to the coronary angiography results, he has an anomalous origin of the RCA that arise from the left sinus, furthermore, there was several stenotic lesions and calcifications in the RCA and other coronary arteries. The possible explanation of the mechanism of its occurrence is the mechanical compression of the RCA by the aorta and the pulmonary artery. We provided the results of the coronary angiography, which addressing the anomalous origin, and the other lesions.
2006
This study describes the coronary artery distribution patterns associated with the anomalous origin of the left coronary artery from the right side of the aortic valve in Syrian hamsters. The hearts of 15 a¡ected animals were examined by means of a corrosion-cast technique, histology and scanning electron microscopy. The hamsters belonged to a laboratory inbred colony with a high incidence of coronary artery anomalies and bicuspid aortic valves. The aortic valve was tricuspid in eight hamsters and bicuspid in the other seven. In all cases, the right coronary artery was normal, whereas the left main coronary artery trunk arose from the right aortic sinus or from the right side of the ventral aortic sinus when the aortic valve was bicuspid. In 12 specimens, the left main trunk crossed the infundibular septum and then divided into the left circum£ex branch and the obtuse marginal branch. In another specimen, the course of the left main trunk was ventral to the right ventricular out£ow tract; in the remaining two, it surrounded the aorta dorsally. In man, some of these distribution patterns may cause myocardial ischaemia and sudden death. The present ¢ndings prove that the origin of the left coronary artery from the right aortic sinus occurs in primitive mammals such as the Syrian hamster, suggesting that the defect may occur in other mammalian species. Its possible occurrence should be borne in mind in domestic animals, especially in those with signs of myocardial ischaemia after strenuous activity. r