Anomalous origin of the right coronary artery from the pulmonary trunk: Is surgical reimplantation into the aorta a method of choice?

Kautzner, Josef; Veselka, Josef; Rohác, J

doi:10.1002/clc.4960190324

Cited by 26 publications

(19 citation statements)

References 7 publications

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“…Las técnicas quirúrgicas disponibles incluyen la ligadura simple de la arteria coronaria derecha, la ligadura de la arteria coronaria derecha con injerto de revascularización coronaria de la vena safena y el reimplante de la arteria coronaria derecha en la aorta. 15 Muchos autores abogan que se debe establecer un sistema de dos arterias coronarias mediante el reimplante directo de la arteria coronaria derecha en la aorta ascendente siempre que sea posible, en especial en los niños. 5 En vista de estas recomendaciones, se sugirió el reimplante de la arteria coronaria derecha en la raíz aórtica inmediatamente después del diagnóstico debido al desenlace mortal potencial.…”

Section: Discussionunclassified

Hallazgo casual de origen anómalo de la arteria coronaria derecha desde la arteria pulmonar en un lactante

2018

Arch Argent Pediatr

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Presentación de casos clinicos RESUMENEl origen anómalo aislado de la arteria coronaria derecha desde la arteria pulmonar principal es una anomalía congénita rara y se han notificado pocos casos en la población pediátrica. En este artículo informamos el caso asintomático de un lactante varón de dos meses de edad al que se le diagnosticó origen anómalo de la arteria coronaria derecha desde la arteria pulmonar principal durante la evaluación realizada para detectar anomalías cardíacas. Debido a la sospecha durante una ecocardiografía, se realizaron un cateterismo cardíaco y una angiografía coronaria para verificar el diagnóstico del origen anómalo de la arteria coronaria derecha desde la arteria pulmonar principal. El paciente se sometió a la cirugía y estaba en buen estado en el seguimiento a los dos meses. El diagnóstico temprano podría evitar que los pacientes tengan complicaciones cardiovasculares. Palabras clave: Ecocardiografía, arteria coronaria, arteria pulmonar, anomalías, cateterismo cardíaco.

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Section: Discussionunclassified

Hallazgo casual de origen anómalo de la arteria coronaria derecha desde la arteria pulmonar en un lactante

2018

Arch Argent Pediatr

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“…Surgical techniques available include simple ligation of the right coronary artery, ligation of the right coronary artery with saphenous vein bypass grafting and reimplantation of the right coronary artery into the aorta. 15 Many authors advocate that, a twocoronary system should be established by direct reimplantation of the RCA into the ascending aorta whenever possible and especially in children. 5 In the light of these recommendations, we suggested reimplantation of the right coronary artery into the aortic root soon after the diagnosis In conclusion, clinicians should be aware of this rare anomaly to make early diagnosis.…”

Section: Discussionmentioning

confidence: 99%

An incidentally detected anomalous origin of the right coronary artery from the pulmonary artery in an infant

Atik

Saltık

Öztarhan

et al. 2018

Arch Argent Pediatr

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Isolated anomalous origin of the right coronary artery from the main pulmonary artery is a rare congenital anomaly, and few cases have been reported in the pediatric age group. Here in, we report an asymptomatic case of a 2-month-old male infant who has been diagnosed as anomalous origin of the right coronary artery from the main pulmonary artery during the evaluation for cardiac abnormalities. For a suspicion on echocardiography, cardiac catheterization and coronary angiography performed to verify the diagnosis of anomalous origin of the right coronary artery from the main pulmonary artery. The patient underwent surgery and did well after two months follow up. Early diagnosis may prevent patients from cardiovascular complications.

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“…Surgical techniques available include simple ligation of the RCA, ligation of the RCA with saphenous vein bypass grafting, and re-implantation of the RCA into the aorta [9]. The aim of surgical correction is to eliminate the left-to-right shunt and establish dual coronary circulation to prevent the potential risk of myocardial ischemia from coronary steal.…”

Section: Discussionmentioning

confidence: 99%

“…When anatomical considerations preclude re-implantation of the RCA into the aorta, ligation of the abnormal pulmonary origin of the coronary artery or arterial bypass grafting should be considered as alternative therapeutic options [5]. However, surgical and pathological reports describe the anomalous RCA as being thin- walled, dilated and vein like structured; therefore, it is thought that the RCA does not tend to normalize in diameter after surgical correction of ARCAPA [9]. Also, symptoms and myocardial ischemia persisted in patients after reimplantation along with dilated coronary arteries with persistent slow runoff into the periphery [9].…”

Section: Discussionmentioning

confidence: 99%

“…However, surgical and pathological reports describe the anomalous RCA as being thin- walled, dilated and vein like structured; therefore, it is thought that the RCA does not tend to normalize in diameter after surgical correction of ARCAPA [9]. Also, symptoms and myocardial ischemia persisted in patients after reimplantation along with dilated coronary arteries with persistent slow runoff into the periphery [9]. Hence, in our patient ligation of RCA with saphenous vein bypass grafting was done as it is recognized as a less traumatic surgical alternative.…”

Section: Discussionmentioning

confidence: 99%

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Anomalous Origin of Right Coronary Artery Originating from the Pulmonary Trunk (ARCAPA): an Incidental Finding in a Patient Presenting with Chest Pain

Balakrishna

Al-Saghir

Minhas

2017

Cureus

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Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest.We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days. Laboratory results showed an elevated troponin of 0.18 ng/ml and subsequently increased to 0.39 ng/ml. The initial electrocardiogram study demonstrated sinus tachycardia with no acute changes. The patient was diagnosed with non-ST-segment elevation myocardial infarction. She underwent cardiac catheterization that showed 90% stenosis of the left main/left anterior descending artery. Reflux of contrast from the right coronary artery (RCA) ostium to the pulmonary artery was seen along with left to right collaterals with retrograde filling of the RCA. There was no significant obstruction of the RCA when viewed via left to right collaterals. Right heart catheterization and pulmonary angiography were performed which confirmed the origin of the RCA from the pulmonary trunk. The patient was referred for surgery and ligation of the aberrant RCA originating from the pulmonary artery was performed along with coronary artery bypass grafting x 2, left internal mammary artery to left anterior descending artery (LAD) and saphenous vein graft to the proximal posterior descending artery. The patient was discharged home with marked improvement of her symptoms.Origin of the RCA from the pulmonary artery (ARCAPA) is a rare congenital malformation with a potentially malignant outcome for the patient. The majority of patients with ARCAPA remain asymptomatic. In this case report, the chest discomfort was due to occlusion of the LAD and was probably unrelated to the coronary malformation. However, sudden cardiac death has been linked to ARCAPA and therefore a corrective operation is recommended even for asymptomatic patients.Of the surgical techniques available, which include: simple ligation of the RCA, ligation of the RCA with saphenous vein bypass grafting and re-implantation of the RCA into the aorta, the last method is believed to be superior for the restoration of myocardial blood supply. However, its long-term benefits have not been conclusively demonstrated. Therefore, in our patient, ligation of RCA with saphenous vein bypass grafting was done as it is recognized as a less traumatic surgical alternative to RCA implantation into the aorta.

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Anomalous origin of the right coronary artery from the pulmonary trunk: Is surgical reimplantation into the aorta a method of choice?

Cited by 26 publications

References 7 publications

Hallazgo casual de origen anómalo de la arteria coronaria derecha desde la arteria pulmonar en un lactante

Hallazgo casual de origen anómalo de la arteria coronaria derecha desde la arteria pulmonar en un lactante

An incidentally detected anomalous origin of the right coronary artery from the pulmonary artery in an infant

Anomalous Origin of Right Coronary Artery Originating from the Pulmonary Trunk (ARCAPA): an Incidental Finding in a Patient Presenting with Chest Pain

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