Right coronary artery from the left sinus of valsalva: Multislice CT and transradial PCI

Bagur, Rodrigo; Gleeton, Onil; Bataille, Yoann; Bilodeau, Sylvie; Rodés‐Cabau, Josep; Bertrand, Olivier

doi:10.4330/wjc.v3.i2.54

Cited by 12 publications

(10 citation statements)

References 7 publications

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“…Although medical therapy may be effective and the least invasive, high intensity physical activity would have to be avoided due to a potential risk of sudden cardiac death. Several cases have been reported on stent implantation therapy for compressed proximal RCA (6,7). However, the long term clinical outcome and stent patency after percutaneous coronary intervention has not yet been confirmed.…”

Section: Discussionmentioning

confidence: 99%

Anomalous Right Coronary Artery Arising from the Left Sinus of Valsalva in a Young Athlete

et al. 2016

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Cardiac events associated with congenital coronary abnormalities are rare but potentially life-threatening in a young population. Most of these patients are not diagnosed before their initial cardiac event. Amongst such coronary artery anomalies, sudden death is frequently seen in an anomalous origination of a coronary artery from the opposite sinus. We herein present the case of a patient who presented with sudden cardiac arrest associated with an anomalous right coronary artery originating from the left sinus of Valsalva. Surgical treatment was selected because there was evidence of reversible ischemia based on the findings of a stress test.

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Section: Discussionmentioning

confidence: 99%

Anomalous Right Coronary Artery Arising from the Left Sinus of Valsalva in a Young Athlete

et al. 2016

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“…The choices of treatment in ACAOS include the following: 1-limitation of a high level of physical exercise, in combination with medical therapy, 2-stent placement into the compressed vessel or 3-surgical treatment. Medical therapy is effective and less invasive; however, a high level of physical exercise must be avoided, since it has a potential risk for sudden cardiac death [7]. Various cases have been reported that underwent stent implantation for a compressed proximal RCA [7].…”

Section: Discussionmentioning

confidence: 99%

“…Medical therapy is effective and less invasive; however, a high level of physical exercise must be avoided, since it has a potential risk for sudden cardiac death [7]. Various cases have been reported that underwent stent implantation for a compressed proximal RCA [7]. However, there is an insufficient data on the long-term clinical outcomes and the duration of the stent patency following percutaneous coronary intervention [7].…”

Section: Discussionmentioning

confidence: 99%

“…Various cases have been reported that underwent stent implantation for a compressed proximal RCA [7]. However, there is an insufficient data on the long-term clinical outcomes and the duration of the stent patency following percutaneous coronary intervention [7]. Surgical treatment is recommended in cases with aberrant RCA showing an interarterial course, if they have signs of cardiac ischemia (class 1, level B evidence) [8].…”

Section: Discussionmentioning

confidence: 99%

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Anomalous Right Coronary Artery: A Rare Cause of Recurrent Syncopal Attacks

2016

Ann Clin Anal Med

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ÖzetKoroner arterin anormal orjini nadirdir, genellikle myokard infarktüsüne ve ventriküler taşikardiye neden olmaz. Biz sol sinüs valsalvadan köken olan ventriküler taşikardi ve myokard infarktüsü ile birliktelik gösteren, nadir bir vaka olan anormal orjinli sağ koroner arteri sunduk. Kırk iki yaşında erkek hasta dış merkezden senkop ve senkop öncesinde belgelenmiş ventriküler taşikardi atağı ile transfer edildi. MPS' de inferior bölgede küçük iskemik alan saptandı. Koroner BT anjiyografide sağ koroner arterin, LMCA' dan ayrı bir ostiumla sol koroner aortik sinüsten kaynaklandığı, aorta ve pulmoner trunk arasında seyrettiği izlendi. Kardiyovasküler cerrahiyle konsültasyondan sonra, düzeltme cerrahisine karar verildi. Cerrahlar tarafından başarılı bir düzeltme cerrahisi yapıldı ve hasta cerrahiden sonra asemptomatikti. Anahtar KelimelerKoroner Arter Anomalisi; Sağ Koroner Arter; İnterarteryal Seyir AbstractAnomalous origin of the coronary artery is a rare anomaly and does not generally lead to myocardial infarction and ventricular tachycardia. We report an uncommon case of anomalous origin of the right coronary artery originating from the left sinus of Valsalva with ventricular tachycardia and myocardial ischemia.A 42-year-old male was transferred from an external facility due to syncope and documented episodes of ventricular tachycardia preceding syncope. MPS showed small ischemic area in the inferior wall. Coronary CT angiography confirmed that RCA was originating from the left coronary aortic sinus with a separate ostium from the LMCA and coursing between the aorta and the pulmonary trunk. After consulting with cardiothoracic surgeons, the decision to perform corrective surgery was made. A successful correction surgery was performed by the surgeons, and the patient was asymptomatic after surgery.

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“…Other approaches include pulmonary artery translocation (30), reimplantation of the anomalous vessel into its appropriate sinus (4, 31), patch augmentation (32), and unroofing (33). Although some case reports on the use of stents to manage AAOCA in adults have been published (7,17), data regarding the long-term prognosis remain scant, and, moreover, stents have limited application in growing children.…”

Section: Table Previously Reported Cases Of Anomalous Aortic Origin mentioning

confidence: 99%

Sudden Cardiac Arrest Associated with an Anomalous Aortic Origin of the Left Coronary Artery from the Opposite Sinus of Valsalva

et al. 2014

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A 13-year-old boy was brought to our hospital after recovering from ventricular fibrillation that occurred after an episode of chest pain during training with his soccer team. Subsequent 64-slice multidetector computed tomography revealed the left coronary artery arising from the right sinus of Valsalva, which coursed between the ascending aorta and root of the main pulmonary artery. Surgical correction including unroofing of the left coronary ostium and pulmonary artery translocation was performed successfully. One year later, he remained asymptomatic and was back on his soccer team. Case ReportA 13-year-old male junior high school student without any past history or familial history of cardiac disease or sudden death had been suffering from occasional chest pain during training with his soccer team. In August 2012, he felt chest pain during training, which required him to take a rest at the school infirmary, where he suddenly fell down and lost consciousness. The patient was resuscitated immediately by the school nurse with cardiac compression and an automated external defibrillator, which detected ventricular fibrillation (Fig. 1). He regained consciousness while being taken to our hospital.Laboratory data showed no significant elevation of either the creatine kinase or troponin I levels. An electrocardiogram (ECG) showed a regular sinus rhythm without J waves, delta waves or Brugada type ST patterns, which were also not detected when using modified precordial leads. The corrected QT interval was 0.442. ECGs of the patient's family members were also examined, which did not show any abnormal findings. Late potential and T-wave alternans were both negative. Transthoracic echocardiography revealed a normal ventricular morphology without segmental wall-motion abnormalities, or valvular disease. Blood-pool scintigraphy using technetium-99m showed normal right and left ventricular systolic functions. No late gadolinium enhancement was noted on cardiac magnetic resonance imaging, and gallium-67 scintigraphy indicated no abnormal accumulation. An epinephrine provocation test showed no significant QT prolongation. A genetic analysis of the most common gene loci (KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2) was negative for long QT syndrome.Subsequent 64-slice multidetector computed tomography revealed an anomalous origin of the left coronary artery arising from the right coronary sinus of Valsalva (Fig. 2A). The left main coronary artery passed between the ascending artery and the root of the main pulmonary artery, which was

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Right coronary artery from the left sinus of valsalva: Multislice CT and transradial PCI

Cited by 12 publications

References 7 publications

Anomalous Right Coronary Artery Arising from the Left Sinus of Valsalva in a Young Athlete

Anomalous Right Coronary Artery Arising from the Left Sinus of Valsalva in a Young Athlete

Anomalous Right Coronary Artery: A Rare Cause of Recurrent Syncopal Attacks

Sudden Cardiac Arrest Associated with an Anomalous Aortic Origin of the Left Coronary Artery from the Opposite Sinus of Valsalva

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