Aortopulmonary window with anomalous origin of the right coronary artery from the pulmonary trunk

Abstract

Anomalous origin of coronary artery originating from the pulmonary artery in conjunction with the aorticopulmonary window (APW) is a rare but a significant anomaly in the era of congenital cardiac diseases. The occurrence of anomalous origin of the right coronary artery from the pulmonary artery among the associated anomalies is less than 5%. The severity of the clinical condition of these patients depends on the degree of left–right shunt and compromise of the pulmonary blood flow. We report surgical management of a case of a 45-day-old infant with APW, ventricular septal defect, and anomalous origin of coronary artery originated from the pulmonary artery.

ARCAPA in Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries

“…Although this was previously reported in the setting of aortopulmonary window and tetralogy of Fallot. 2 , 3 , 4 , 5 A similar case was noted in a previous ARCAPA case series published in 2006, 5 in a patient with tetralogy, pulmonary atresia with right pulmonary artery off the descending aorta, and left pulmonary artery off the ascending aorta. This patient was diagnosed with ARCAPA intraoperatively following RCA ligation and died on the first postoperative day.…”

Cardiac imaging findings in anomalous origin of the coronary arteries from the pulmonary artery; narrative review of the literature

“…When it is associated with ARCAPA, the pulmonary artery pressure is kept high therefore the flow in the anomalous coronary artery is maintained and myocardial ischemia usually doesn’t develop. Moreover, there is no sign of dilation or tortuosity in coronary arteries and collateral circulation in contrast to isolated ARCAPA in echocardiography [ 35 , 36 ].…”