Incidental finding of an ARCAPA during angiography

Abstract

Anomalous coronary arteries are rare conditions, especially when the origin of the right coronary artery comes from the trunk of the pulmonary artery. The manifestations of the disease can occur at an early stage, leading to sudden death, myocardial infarction or ischemic cardiomyopathy. Many reported cases have been asymptomatic for long periods. Surgery is always indicated as seen in most of the literature. We describe an angiographic case of an oligosymptomatic 76-year old patient referred for elective coronary angiography for preoperative evaluation of prostate surgery. Although surgical treatment is the first choice, especially in early diagnosis, this patient was referred for a conservative treatment.

Anomalous right coronary artery origin from pulmonary artery associated with aortic stenosis, mitral regurgitation, and Vieussens’ arterial ring: a very rare association and case

“…Surgical correction of our symptomatic patient with severe AS, severe MR, ARCAPA, and VAR was considered the preferred treatment, to correct the cardiac valve diseases, to establish a dual coronary system and to reduce the risk of sudden cardiac death associated with having a single coronary system. It should be noted that that elderly patients with isolated ARCAPA can occasionally be asymptomatic or oligosymptomatic, mainly when the collateral circulation from normal LCA results in a good or acceptable LV perfusion, and can be referred for conservative treatment [6]. Symptomatic patients with ARCAPA, severe AS, and severe MR who have a high surgical risk, could similarly benefit from a conservative treatment limited to transcatheter aortic-valve replacement (TAVR) without the ARCAPA correction.…”

Percutaneous treatment of anomalous origin of the right coronary artery with malignant course in a patient with aborted sudden death

“…11 A third study, conducted by Araújo et al, described a rare case of anomalous origin of the right coronary artery, from the pulmonary artery with conservative treatment. 13 At the time, this case report and recent studies demonstrated percutaneous treatment of coronary anomalies with stent implantation is a safe option for selected patients, taking into account the clinical presentation, anatomy study, and training of the cath lab team.…”