Case 3/2017 - High Origin of the Right Coronary Artery at the Sinotubular Junction, in a 14-Year-Old Teenager, in Diagnostic Imaging Diversity

Atik, Edmar; Leal, G. G.

doi:10.5935/abc.20170048

Cited by 1 publication

(2 citation statements)

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“…Limited case reports have documented the repair of high aortic origin of the RCA in an adult population and are summarized in Table 1. In a single‐institution, prospective cohort, Molossi et al note that aortic origins of the coronary artery above the coronary commissure are the rarest anatomic variant presenting in only 2.4% (of either isolated right or left coronary artery origins) of patients with anomalous coronary origins 3,5,6,8–16 . Notably, difficulty in cannulating the RCA during diagnostic coronary angiography has been previously noted as well as the need for caution in applying an aortic cross‐clamp and administering cardioplegia for success 8,12 .…”

Section: Discussionmentioning

confidence: 99%

“…origins. 3,5,6,[8][9][10][11][12][13][14][15][16] Notably, difficulty in cannulating the RCA during diagnostic coronary angiography has been previously noted as well as the need for caution in applying an aortic cross-clamp and administering cardioplegia for success. 8,12 However, no prior publication has documented the presence or operative consideration of such an anatomic variant in the concomitant setting of an ascending aortic aneurysm repair.…”

Section: Case Presentationmentioning

confidence: 99%

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Repair of an ascending aortic aneurysm associated with an anomalous right coronary artery origin

Desai

Hisamoto

2022

Journal of Cardiac Surgery

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Background: Anomalous right coronary artery (RCA) origin off the ascending aorta, above the level of the sinus of Valsalva, is rare and can be associated with altered hemodynamics, decreased coronary perfusion, and presents unique considerations during intraoperative management in the surgical treatment of concomitant ascending aneurysmal disease.Case Presentation: A 58-year-old female with prior symptomatic visceral aneurysmal rupture and cerebrovascular disease presented with a 5 cm ascending aortic aneurysm, elevated aortic index, and increased rupture risk factors. She was preoperatively diagnosed with an anomalous, high RCA origin off the ascending aorta 15 mm above the sinotubular junction. She underwent successful ascending aortic repair using a 28 mm Dacron hemiarch graft with reimplantation of an RCA button. Conclusion:Our successful reconstructive surgical repair using an RCA button is effective management for high anomalous RCA take-offs from the ascending aorta and presents the first documented case of this rare coronary anomaly in the context of ascending aortic aneurysmal disease.

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Section: Discussionmentioning

confidence: 99%