Korean Circ J.  2017 Jan;47(1):144-147. 10.4070/kcj.2016.0174.

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

• Al-Dairy A
• Rezaei Y
• Pouraliakbar H
• Mahdavi M
• Bayati P
• Gholampour-Dehaki M

• KMID: 2365295
• DOI: http://doi.org/10.4070/kcj.2016.0174

Abstract

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare congenital heart defect. Herein, we describe three cases of ARCAPA in an 8 months old, 18 months old, and 4 year old child. Two cases were incidentally diagnosed using a computed tomographic angiograph, and the other was incidentally diagnosed using a coronary angiograph. These cases underwent a reimplantation technique on diagnosis and resulting in positive clinical outcomes during the follow-up period which was a mean of 1.5 years.

Keyword

Congenital abnormalities; Coronary vessel anomalies; Cardiac surgical procedures; Electrocardiography

MeSH Terms

Cardiac Surgical Procedures
Child
Congenital Abnormalities
Coronary Vessel Anomalies
Coronary Vessels*
Diagnosis
Electrocardiography
Follow-Up Studies
Heart Defects, Congenital
Humans
Pulmonary Artery*
Replantation

Figure

• 

  Fig. 1 Preoperative diagnostic images of the anomalous right coronary artery. (A) Computed tomographic angiography showing the anomalous right coronary artery originating from the pulmonary artery in coronal view, (B) sagittal view, (C) zoomed view, and (D) three-dimensional view. RCA: right coronary artery, AO: aorta, PUL: pulmonary artery, LM: left main coronary artery.

Reference

1. Li RJ, Yang Y, Li ZA, Xie JJ, Zhang XS. Right coronary artery arising from the main pulmonary artery: Evaluation with 2-dimensional transthoracic echocardiography and multislice computed tomography. Tex Heart Inst J. 2010; 37:376–377.

2. Choi E, Park JJ, Yoon TJ, Kim YH, Ko JK, Park IS, et al. Anomalous origin of the right coronary artery from the pulmonary artery. Korean J Thorac Cardiovasc Surg. 2002; 35:894–897.

3. Park CS, Kim W, Hong SB, Hwang SH, Kim W, An BH. Anomalous origin of the right coronary artery from the main pulmonary artery presenting as angina pectoris in an adult. Korean Circ J. 2008; 38:627–629.

4. Gupta R, Marwah A, Shrivastva S. Anomalous origin of right coronary artery from pulmonary artery. Ann Pediatr Cardiol. 2012; 5:95–96.

5. Brooks HS. Two cases of an abnormal coronary artery of the heart arising from the pulmonary artery: With some remarks upon the effect of this anomaly in producing cirsoid dilatation of the vessels. J Anat Physiol. 1885; 20(Pt 1):26–29.

6. Maroules CD, Adams DZ, Whiting ED, Antevil JL, Mitchell ES. Anomalous origin of the right coronary artery from the pulmonary artery: Evaluation with use of 64-slice multidetector computed tomography. Tex Heart Inst J. 2013; 40:106–108.

7. Winner MW 3rd, Raman SV, Sun BC, Crestanello JA. Preoperative assessment of anomalous right coronary artery arising from the main pulmonary artery. Case Rep Med. 2011; 2011:642126.

8. Williams IA, Gersony WM, Hellenbrand WE. Anomalous right coronary artery arising from the pulmonary artery: A report of 7 cases and a review of the literature. Am Heart J. 2006; 152:1004.e9–1004.e17.

9. Kuba PK, Sharma J, Sharma A. Successful surgical treatment of a septuagenarian with anomalous right coronary artery from the pulmonary artery with an eleven year follow-up: Case report and review of literature. Sultan Qaboos Univ Med J. 2013; 13:169–174.

10. Hauser M. Congenital anomalies of the coronary arteries. Heart. 2005; 91:1240–1245.