Korean Circ J.  2014 May;44(3):193-195. 10.4070/kcj.2014.44.3.193.

Aorta-Right Atrial Tunnel: An Interesting Type of a Congenital Coronary Artery Anomaly

• Iyisoy A
• Celik T
• Celik M
• Sag C

• KMID: 2145482
• DOI: http://doi.org/10.4070/kcj.2014.44.3.193

Abstract

An 18-year-old girl with an aortico-right atrial tunnel originating from the left sinus of Valsalva, in which the left anterior descending and circumflex coronary arteries arose independently from the different parts of the tunnel, was reported. In the differential diagnosis of continuous murmur, this type of tunnel should be taken into consideration. Surgical approach should be offered.

Keyword

Coronary vessel anomalies; Fistula; Aneurysm

MeSH Terms

Adolescent
Aneurysm
Coronary Vessel Anomalies
Coronary Vessels*
Diagnosis, Differential
Female
Fistula
Humans
Sinus of Valsalva

Figure

• 

  Fig. 1 Selective left coronary angiography at the right anterior oblique view (A) shows aorto-right atrial tunnel. LAD and LCX originate from the aorto-right atrial tunnel. The left lateral view (B) demonstrates the tunnel ending with the aneurysms into the right atrium. LAD: left anterior descending coronary artery, LCX: left circumflex.

• 

  Fig. 2 CT angiography (curved MIP) (A) demonstrates aorta-right atrial tunnel ending with a large aneursym just before entering into the right atrium and a smaller calcified circular aneurysm than the distal one; and volume-rendered 3-D image (B) demonstrating that the LAD and LCX arteries originate directly from the tunnel. LAD: left anterior descending coronary artery, RCA: right coronary artery, LCX: left circumflex.

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