Coronary artery bypass grafting experience in the setting of an anomalous origin of the right coronary artery from the left sinus of Valsalva: Midterm results

Ibraheem, Waleed I; Abass, osama; Toema, Ahmed; Yehia, Ahmed

doi:10.1111/jocs.14234

Cited by 14 publications

(14 citation statements)

References 22 publications

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“…Despite being founded just on retrospective single-center case series and registry data, Nord American and European guidelines recommend surgery for symptomatic patients ( 2 , 3 ). However, several surgical procedures are available whose complexity ranges greatly ( 1 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

Transit time flow measurement guiding the surgical treatment for anomalous origin of the right coronary artery: A case report

Jiritano

Leone

Greco

et al. 2022

Front. Cardiovasc. Med.

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Anomalous origin of a coronary artery from the opposite sinus of Valsalva (ACAOS) in symptomatic patients is a rare but serious finding whose treatment consists of a surgical correction. The surgical treatment has a level of complexity that could vary from unroofing and ostioplasty to coronary artery bypass grafting. We present our management of a 59-year-old woman presenting with chest pain and dyspnea for right ACAOS with an interarterial route. The right coronary artery (RCA) was bypassed with the right internal thoracic artery. An intraoperative transit time flowmetry (TTFM) showed a competitive flow from the native RCA. RCA proximal ligation site was identified intraoperatively, considering the best mean graft flow (MGF) and the absence of ischemic events. The patient was discharged after a week without adverse events. The 1-year follow-up was uneventful. The intraoperative use of TTFM could guide the surgeon’s hand making straightforward the surgical treatment for ACAOS.

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Section: Discussionmentioning

confidence: 99%

Transit time flow measurement guiding the surgical treatment for anomalous origin of the right coronary artery: A case report

Jiritano

Leone

Greco

et al. 2022

Front. Cardiovasc. Med.

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“…This traditional technique is performed in the usual fashion ( Figure 10 ). CABG alone may be best suited when other procedures are contraindicated, such as in AAOCA with severe proximal narrowing or in older patients with diffuse atherosclerosis ( 15 , 26 ), where it shows good early and midterm results. However, CABG, usually with an internal mammary artery bypass, is not recommended in young patients.…”

Section: Operative Techniquesmentioning

confidence: 99%

Surgery for Anomalous Aortic Origin of Coronary Arteries: Technical Safeguards and Pitfalls

Padalino

Jegatheeswaran

Blitzer

et al. 2021

Front. Cardiovasc. Med.

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Anomalous aortic origin of a coronary artery (AAOCA) is reported as the second leading cause of sudden cardiac death in otherwise healthy young individuals. Several surgical studies have reported a shallow operative risk, describing repair as safe and effective with short or medium-term follow-up. However, surgical repair can also be associated with a high risk of complications. Numerous repair techniques have been described in the literature, but each technique's indications and limitations are often not well-understood or understated. Since explicit technical knowledge of the most appropriate surgical technique is highly desirable, we sought to thoroughly and clearly outline the safeguards and pitfalls of the most common surgical techniques used to repair AAOCA.

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“…Reimplantation of the anomalous ostium has also been proposed, but stenosis of the new ostium can occur, resulting in reoperation and need of CABG surgery. 30 However, while some authors reported CABG to be the most straightforward solution, 31,32 other studies suggest that CABG should be avoided in the absence of concomitant obstructive coronary artery disease, because competitive flow from native vessels can cause graft failure. 4 There is only limited evidence on the role of percutaneous coronary intervention (PCI) in patients with interarterial coronary artery segment.…”

Section: Therapy Of Caasmentioning

confidence: 99%

Anomalous Left Coronary Artery Originating from the Right Coronary Sinus with an Interarterial Course: a Case Report and Literature Review

Simon

Panajotu

Csőre

et al. 2020

Journal of Cardiovascular Emergencies

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AbstractIntroduction: The diagnosis of coronary artery anomalies (CAAs) can be challenging due to the highly variable manifestations and symptoms. CAAs occur in less than 1% of the population. Multidetector cardiac computed tomography angiography (CTA) provides excellent spatial and temporal resolution for the imaging of CAAs. This case report describes an anomalous origin of the left main coronary artery.Case presentation: A 64-year-old woman with atypical chest pain underwent coronary CTA. The CT demonstrated that the left coronary artery was originating from the right coronary sinus and had an interarterial course with an approximately 50% stenosis at the segment between the great arteries. Invasive coronary angiography confirmed hemodynamically significant stenosis of the interarterial segment. The patient underwent off-pump coronary artery bypass graft surgery.Conclusion: Left coronary artery originating from the right coronary sinus with an interarterial course increases the risk of sudden cardiac death. In these patients, surgical revascularization is recommended. However, timely diagnosis, especially in those with mild symptoms, remains challenging. Coronary CTA is a robust tool to diagnose CAA and provides valuable information to support the clinical decision making in this patient population.

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Coronary artery bypass grafting experience in the setting of an anomalous origin of the right coronary artery from the left sinus of Valsalva: Midterm results

Cited by 14 publications

References 22 publications

Transit time flow measurement guiding the surgical treatment for anomalous origin of the right coronary artery: A case report

Transit time flow measurement guiding the surgical treatment for anomalous origin of the right coronary artery: A case report

Surgery for Anomalous Aortic Origin of Coronary Arteries: Technical Safeguards and Pitfalls

Anomalous Left Coronary Artery Originating from the Right Coronary Sinus with an Interarterial Course: a Case Report and Literature Review

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