Surgical Repair for Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery

Al-Dairy, Alwaleed; Rezaei, Yousef; Pouraliakbar, Hamidreza; Mahdavi, Mohammad; Bayati, Parvin; Gholampour-Dehaki, Maziar

doi:10.4070/kcj.2016.0174

Cited by 24 publications

(18 citation statements)

References 6 publications

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“…Embryologically, coronary artery anomalies appear as a result of either malrotation of the spiral septum dividing the truncus or malpositioning of the coronary buds themselves. 3 …”

Section: Discussionmentioning

confidence: 99%

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Anomalous origin of coronary arteries from pulmonary artery in adults: a case series

Vergara-Uzcategui

Neves

Salinas

et al. 2020

European Heart Journal - Case Reports

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Background Anomalous origin of a coronary artery from the pulmonary trunk is a small group of rare congenital anomalies present in up to 1% of the population. These patients, in absence of an adequate collateral supply, may present with congestive heart failure secondary to ischaemia, arrhythmia, or sudden cardiac death in up to 90% of cases within the first months of life. Case summary We present four cases diagnosed in adulthood over 10 years in two high-volume centres. The first patient presented with dyspnoea and orthopnoea. The second with chest pain and episodes of non-sustained ventricular tachycardia. The third patient presented during her third pregnancy with chest pain, palpitations, and arrhythmia (non-sustained ventricular tachycardia). The fourth patient presented with sudden cardiac death. Discussion In all cases with anomalous origin of coronary arteries, it is recommendable to consider surgical correction to avoid the progression of ischaemia, congestive heart failure, arrhythmia, and sudden death.

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“…Embryologically, coronary artery anomalies appear as a result of either malrotation of the spiral septum dividing the truncus or malpositioning of the coronary buds themselves. 3 …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, patients with a dominant RCA system do not tolerate the ARCAPA circulation compared with those with a left dominant coronary tree. 3 …”

Section: Discussionmentioning

confidence: 99%

Anomalous origin of coronary arteries from pulmonary artery in adults: a case series

Vergara-Uzcategui

Neves

Salinas

et al. 2020

European Heart Journal - Case Reports

View full text Add to dashboard Cite

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“…Echocardiography is noninvasive, convenient, and safe but provides insufficient visualization of the size and course of the entire coronary artery, due to suboptimal image quality [Robinson 2014]. In our case, the initial diagnosis was suggested by the Surgery is recommended upon the diagnosis of ARCAPA, even in completely asymptomatic patients to prevent sudden death from myocardial ischemia [Al-Dairy 2017]. Surgical approach includes either reimplantation of the anomalous right coronary artery or ligation of the right coronary artery at its origin from the pulmonary artery with or without concomitant grafting to itself [Al-Dairy 2017].…”

Section: Discussionmentioning

confidence: 87%

Anomalous Right Coronary Artery Arising from the Pulmonary Artery with Associated Enlargement of the Left Coronary Artery: A Case Report

Cao

et al. 2021

HSF

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An anomalous right coronary artery arising from the pulmonary artery (ARCAPA) is among the least common form of congenital coronary anomalies, accounted for the incidence of only 0.002% in the general population. Most ARCAPA patients have no symptoms but may develop myocardial ischemia. Surgical correction of the anomaly is recommended to prevent subsequent fatal outcomes. Here, we reported a case of a 2-year-old female child initially hospitalized for diarrhea, but later diagnosed with an ARCAPA through echocardiogram and computed tomography. Surgical reimplantation of the right coronary artery from the pulmonary artery to the ascending aorta was performed. The patient recovered well from the surgery with no postoperative complications. In the follow-up assessments, normal coronary function and myocardial effusion were demonstrated.

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“…Once ARCAPA is identified, surgical correction is advocated as the definitive treatment to reduce the risk of sudden cardiac death associated with having a single coronary system [ 13 ]. The anomalous RCA can be either re-implanted to the aorta or ligated [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain

2018

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Patient: Female, 58Final Diagnosis: Anomalous origin of RCA from PA with reversible myocardial ischemia of the inferior wallSymptoms: Chest pain • shortness of breathMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Congenital defects/diseasesBackground:Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital anomaly with an incidence of 0.002%.Case Report:A 58-year-old African American female with a history of diabetes mellitus, hyperlipidemia, and hypertension was evaluated for shortness of breath and chest heaviness. On physical examination, she was found to be morbidly obese. Her blood pressure was 160/90 mmHg. There were no carotid bruits or jugular venous distension. Cardiac auscultation showed distant heart sounds with no audible murmurs. Lower extremity examination showed +1 edema with weak pedal pulses. ECG showed non-specific ST segment and T-wave changes. Echocardiogram demonstrated dysfunction grade I with preserved ejection fraction. An adenosine nuclear study showed an area of reversible ischemia of the inferior wall. Selective left coronary angiography showed the left coronary artery (LCA) originating from the left sinus of Valsalva. From the LCA, the left anterior descending and the left circumflex coronary arteries arose in a typical course. The right coronary artery (RCA) was visualized in a retrograde fashion via collaterals originating from the left coronary system and it drained into the pulmonary artery. On aortic root angiography, the origin of the RCA could not be determined. The patient’s surgical risk was deemed unacceptably high and she was not considered a surgical candidate. Her symptoms were controlled conservatively.Conclusions:By reporting this case, we shed some light on a rare congenital anomaly involving the coronary arteries. Variable presentations have been described for ARCAPA, however, many patients remain asymptomatic. Diagnosis can be confirmed by coronary angiography. Surgical correction is the definitive treatment.

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Surgical Repair for Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery

Cited by 24 publications

References 6 publications

Anomalous origin of coronary arteries from pulmonary artery in adults: a case series

Anomalous origin of coronary arteries from pulmonary artery in adults: a case series

Anomalous Right Coronary Artery Arising from the Pulmonary Artery with Associated Enlargement of the Left Coronary Artery: A Case Report

Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain

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