Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus: Case report

Sarfaraz, Ziyab K.; Siddiqi, Mohammad Salman; Kindi, Adil H. Al; Alameddine, Tarek

doi:10.18295/squmj.2017.17.03.017

Cited by 3 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reimplantation of the anomalous ostium has also been proposed, but stenosis of the new ostium can occur, resulting in reoperation and need of CABG surgery. 30 However, while some authors reported CABG to be the most straightforward solution, 31,32 other studies suggest that CABG should be avoided in the absence of concomitant obstructive coronary artery disease, because competitive flow from native vessels can cause graft failure. 4 There is only limited evidence on the role of percutaneous coronary intervention (PCI) in patients with interarterial coronary artery segment.…”

Section: Therapy Of Caasmentioning

confidence: 99%

Anomalous Left Coronary Artery Originating from the Right Coronary Sinus with an Interarterial Course: a Case Report and Literature Review

Simon

Panajotu

Csőre

et al. 2020

Journal of Cardiovascular Emergencies

View full text Add to dashboard Cite

AbstractIntroduction: The diagnosis of coronary artery anomalies (CAAs) can be challenging due to the highly variable manifestations and symptoms. CAAs occur in less than 1% of the population. Multidetector cardiac computed tomography angiography (CTA) provides excellent spatial and temporal resolution for the imaging of CAAs. This case report describes an anomalous origin of the left main coronary artery.Case presentation: A 64-year-old woman with atypical chest pain underwent coronary CTA. The CT demonstrated that the left coronary artery was originating from the right coronary sinus and had an interarterial course with an approximately 50% stenosis at the segment between the great arteries. Invasive coronary angiography confirmed hemodynamically significant stenosis of the interarterial segment. The patient underwent off-pump coronary artery bypass graft surgery.Conclusion: Left coronary artery originating from the right coronary sinus with an interarterial course increases the risk of sudden cardiac death. In these patients, surgical revascularization is recommended. However, timely diagnosis, especially in those with mild symptoms, remains challenging. Coronary CTA is a robust tool to diagnose CAA and provides valuable information to support the clinical decision making in this patient population.

show abstract

Section: Therapy Of Caasmentioning

confidence: 99%

Anomalous Left Coronary Artery Originating from the Right Coronary Sinus with an Interarterial Course: a Case Report and Literature Review

Simon

Panajotu

Csőre

et al. 2020

Journal of Cardiovascular Emergencies

View full text Add to dashboard Cite

show abstract

“…AORL is more likely to cause sudden cardiac death when the acute take-off angle is <30°, but no relationship has been found between the interarterial course length and sudden cardiac arrest (10). Many studies have analyzed data from clinical cases and autopsy reports in order to understand the risk of AORL and propose treatment options (7,(11)(12)(13)(14)(15). Some studies have simulated the hemodynamics of AORL through computational fluid dynamics.…”

Section: Introductionmentioning

confidence: 99%

Transient numerical simulation of the right coronary artery originating from the left sinus and the effect of its acute take-off angle on hemodynamics

Cong

Zhao

Dai

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: An anomalous origin of the right coronary artery from the left coronary artery sinus is usually characterized by an acute take-off angle. Most affected patients have no clinical symptoms; however, some patients have decreased blood flow into the right coronary artery during exercise, which can lead to symptoms such as myocardial ischemia. Most researchers who have studied an anomalous origin of the right coronary artery from the left coronary artery sinus have done so through clinical cases. In this study, we used numerical simulation to evaluate the hemodynamics of this condition and the effect of an acute take-off angle on hemodynamic parameters. We expect that the results of this study will help in further understanding the clinical symptoms of this anomaly and the hemodynamic impact of an acute take-off angle.Methods: Three-dimensional models were reconstructed based on the computed tomography images from 16 patients with a normal right coronary artery and 26 patients with an anomalous origin of the right coronary artery from the left coronary artery sinus. A numerical simulation of a two-way fluid-structure interaction was executed with ANSYS Workbench software. The blood was assumed to be an incompressible Newtonian fluid, and the vessel was assumed to be an isotropic, linear elastic material. Hemodynamic parameters and the effect of an acute take-off angle were statistically analyzed.Results: During the systolic period, the wall pressure in the right coronary artery was significantly reduced in patients with an anomalous origin of the right coronary artery (t =1.32 s, P=0.0001; t =1.34-1.46 s, P<0.0001). The wall shear stress in the abnormal group was higher at the beginning of the systolic period (t =1.24 s, P=0.0473; t =1.26 s, P=0.0193; t =1.28 s, P=0.0441). The acute take-off angle was smaller in patients with clinical symptoms (27.81°±4.406°) than in patients without clinical symptoms (31.86°±2.789°; P=0.017). In the symptomatic group, pressure was negatively correlated with the acute take-off angle (P=0.0185-0.0341, r=−0.459 to −0.4167). Conclusions:This study shows that an anomalous origin of the right coronary artery from the left coronary artery sinus causes changes in hemodynamic parameters, and that an acute take-off angle in patients with this anomaly is associated with terminal ischemia of the right coronary artery.

show abstract

“…The incidence of an anomalous right coronary artery originating from the left coronary sinus on coronary angiography is 0.019% to 0.49% [1]. Often, patients present with sudden death or myocardial ischemia [2]. Most patients remain asymptomatic and have no ischemic symptoms or findings on resting or stress electrocardiography (ECG); therefore, they are diagnosed only on coronary imaging [3].…”

Section: Introductionmentioning

confidence: 99%

A Case of an Anomalous Right Coronary Artery Arising from the Left Coronary Cusp

Rawala¹,

Longi²,

Khan³

et al. 2019

Cureus

View full text Add to dashboard Cite

An anomalous origin of the right coronary artery is usually asymptomatic. It is mostly found incidentally on an invasive diagnostic angiogram. It does lead to an increased risk of sudden cardiac death, especially in younger patients. We present a case of a 41-year-old who had presented to the hospital with complaints of chest pain. The patient was evaluated by cardiology who performed an angiography that identified an anomalous origin of the right coronary artery arising from the left coronary cusp but no evidence of coronary artery disease. Once identified, these anomalous vessels should be corrected surgically, as these conditions increase the risk of sudden cardiac death arrhythmia and ischemic events.

show abstract

Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus: Case report

Cited by 3 publications

References 9 publications

Anomalous Left Coronary Artery Originating from the Right Coronary Sinus with an Interarterial Course: a Case Report and Literature Review

Anomalous Left Coronary Artery Originating from the Right Coronary Sinus with an Interarterial Course: a Case Report and Literature Review

Transient numerical simulation of the right coronary artery originating from the left sinus and the effect of its acute take-off angle on hemodynamics

A Case of an Anomalous Right Coronary Artery Arising from the Left Coronary Cusp

Contact Info

Product

Resources

About