Anomalous origin of the right coronary artery from the pulmonary artery: surgical re-implantation into the aorta

Abstract

Anomalous origin of the right coronary artery from the pulmonary artery is rare (only 200 cases have been reported in total), potentially life-threatening and with an uncertain prognosis. Patient characteristics are only available in half the reported cases. Easy to miss, anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is usually diagnosed in association with concomitant cardiac anomalies. Techniques for its correction are rarely discussed, but the restoration of a two-coronary system is optimal. We report details of the surgical repair of ARCAPA in a 17-year-old man to highlight important anatomical features.

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

“…5 Los casos de ARCAPA son más raros que los de ALCAPA (se han notificado solo 200 casos en total). 1 Dado que muchos pacientes no presentan síntomas, la incidencia real de esta anomalía coronaria podría ser mayor. 2 En el 70% de los casos notificados, esta fue una anomalía aislada.…”

“…1 La primera serie de pacientes fue descrita por Brooks en Hallazgo casual de origen anómalo de la arteria coronaria derecha desde la arteria pulmonar en un lactante…”

Thrombosis in the Surgically Corrected Anomalous Right Coronary Artery after Reimplantation in Aorta

“…Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare yet potentially life-threatening condition [ 1 ]. In adults with ARCAPA, the RCA wall tends to be very thin and fragile and serves as a retrograde venous conduit from the left coronary circulation into the pulmonary artery [ 1 , 2 ].…”

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

“…5 Anomalous origin of the right coronary artery from the pulmonary artery is rare than ALCA-PA (only 200 cases have been reported in total). 1 As many patients remain asymptomatic, the true incidence of this coronary anomaly might be higher. 2 In 70% of reported cases, it is an isolated anomaly.…”

“…1 The first case series was described by Brooks in 1885. 2 Based on a literature review done by Modi et al in 2010, 20 cases were diagnosed in infants (≤ one year of age), 44 cases were diagnosed in children (≤18 years of age), 17 cases were in adults (>60 years of age), and in eight cases, the age was not recorded.…”