Anomalous origin of the right coronary artery from the pulmonary artery

Wald, Stewart; Stonecipher, Keith; Baldwin, Brian J.; Nutter, Donald O.

doi:10.1016/0002-9149(71)90235-9

Cited by 50 publications

(14 citation statements)

References 5 publications

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“…However, there are some cases of sudden death from ARCAPA cases shown at autopsy, ranging from infants to elderly patients. 1,4 In the current case, ECG demonstrated myocardial ischemia when the infant was crying, but not in the resting state. Some older patients have been diagnosed with this anomaly after they showed signs of heart failure or angina.…”

Section: Discussionmentioning

confidence: 49%

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Surgical treatment of an infant with myocardial ischemia due to an anomalous origin of the right coronary artery from the main pulmonary artery: Report of a case

et al. 2009

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An anomalous origin of the right coronary artery from the main pulmonary artery (ARCAPA) is a rare cardiac malformation, and only three cases of isolated ARCAPA in patients younger than 2 years of age have been reported. This report describes the surgical treatment of a 12-month-old girl with myocardial ischemia due to ARCAPA. The diagnosis was made by echocardiography. A reimplantation of the aberrant coronary artery was performed, and the patient had a successful postoperative course.

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Section: Discussionmentioning

confidence: 49%

“…Only three cases of isolated ARCAPA have been reported in patients younger than 2 years old. [1][2][3][4][5][6] This report describes the surgical treatment of a 12-month-old girl with myocardial ischemia due to this anomaly.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of an infant with myocardial ischemia due to an anomalous origin of the right coronary artery from the main pulmonary artery: Report of a case

et al. 2009

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“…Because the course and peripheral distribution of the RCA are normal in isolated cases, this anomaly generally does not cause any typical clinical findings. The prognosis of this anomaly is much better than that of Bland-White-Garland syndrome, and a limited number of sudden deaths 2,3 and cardiac arrest during dancing 4 have been reported.…”

Section: Discussionmentioning

confidence: 92%

Off-Pump Reimplantation of Anomalous Origin of the Right Coronary Artery.

et al. 2001

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n anomalous origin of the right coronary artery from the pulmonary artery is rare compared to BlandWhite-Garland syndrome. 1 With understanding of the anatomy and physiology of the anomalous vessel, offpump reimplantation of the anomalous origin of the right coronary from the pulmonary artery to the aorta was successfully performed through a mini-sternotomy. Case ReportA 30-year-old man was referred to the outpatient clinic for evaluation of to-and-fro murmur, which was first noted at age 7 years. Physical examination and chest X-ray showed no specific changes. A treadmill stress electrocardiograph (ECG) was positive for ischemia (Fig 1) with chest oppression. By right heart catheterization, a left-to-right shunt was detected (Qp/Qs 1.58). Coronary angiography showed the right coronary artery (RCA) filled retrogradely from the left side, and flow of contrast material into the pulmonary artery was visible (arrow, Fig 2A). The location of the ostium of the RCA was extremely high and it originated from the right side of the pulmonary artery. Images from transesophageal echocardiography confirmed the findings (arrow, Fig 2B).Surgical correction was performed through an upper mini-sternotomy ( Fig 2C). The ostium of the enlarged tortuous thin-walled RCA was recognized 25 mm above the free margin of the pulmonary valve. The mean flow of the RCA was measured by a magnetic flow meter as 1,500 ml/min in the direction toward the pulmonary artery. The proximal portion of the RCA was mobilized free carefully from fatty tissue around and collateral vessel. The RCA was clamped distally by a micro bulldog clamp. The proximal portion of the RCA was simply ligated and excised. The Japanese Circulation Journal Vol.65, May 2001 RCA was reimplanted into the aortic root, using a partialocclusion clamp, and the flow decreased to 270 ml/min.A postoperative angiogram showed normally directed coronary blood flow and diminished intercoronary anastomosis (Fig 2D). The postoperative course was uneventful and the patient was discharged with complete disappearance of symptoms. DiscussionAn anomalous origin of the RCA from the pulmonary artery is occasionally found at autopsy and angiography, and is incidentally noted during open heart surgery for other cardiac defects. Because the course and peripheral distribution of the RCA are normal in isolated cases, this anomaly generally does not cause any typical clinical findings. The prognosis of this anomaly is much better than that of Bland-White-Garland syndrome, and a limited number of sudden deaths 2,3 and cardiac arrest during dancing 4 have Jpn Circ J 2001; 65: 471 -472 (Received November 27, 2000; revised manuscript received December 25, 2000; accepted January 9, 2001 A 30-year-old man was diagnosed to have an anomalous origin of the right coronary from the pulmonary artery. Through a mini-sternotomy, without extracorporeal circulation, reimplantation of the anomalous origin of the right coronary artery from the pulmonary artery to the aorta was successfully performed. This is a succe...

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“…bei 10) beobachtete fehlende Nachweis einer signifikanten Gefäßsklerose der RCA im Kontrast zu den ausgeprägten diffusen Wandveränderungen beider Äste der linken Koronararterie. Er wird auf die geringe Druckbelastung der retrograd perfundierten und von verschiedenen Autoren als venenartig beschriebenen RCA bezogen (3,7,10,11,13,16,17,22).…”

Section: Kasuistikunclassified

Manifestation einer Ursprungsanomalie der rechten Koronararterie aus der A. pulmonalis nach Entwicklung einer bedeutsamen koronaren Herzkrankheit

Rübesamen¹,

Wieser²,

Jadonic³

1999

Z Kardiol

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We describe a 71-year-old man with a history of a small posterior myocardial infarction. Angiographically he showed a coronary artery disease with major proximal stenosis of both branches of the left coronary artery and an occlusion of the marginal branch of the circumflex artery (infarct-related vessel). As an unexpected finding, an anomalous origin of the right coronary artery from the pulmonary artery was also found. This rare condition may cause development of ischemia with potentially lethal complications as a result of coronary steal phenomenon. Surgical treatment is, therefore, indicated even in asymptomatic patients with this anomaly. Possible surgical procedures and there indications are discussed.

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Anomalous origin of the right coronary artery from the pulmonary artery

Cited by 50 publications

References 5 publications

Surgical treatment of an infant with myocardial ischemia due to an anomalous origin of the right coronary artery from the main pulmonary artery: Report of a case

Surgical treatment of an infant with myocardial ischemia due to an anomalous origin of the right coronary artery from the main pulmonary artery: Report of a case

Off-Pump Reimplantation of Anomalous Origin of the Right Coronary Artery.

Manifestation einer Ursprungsanomalie der rechten Koronararterie aus der A. pulmonalis nach Entwicklung einer bedeutsamen koronaren Herzkrankheit

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