High origin of the right coronary artery with congenital heart disease

Echocardiographic diagnosis of clinically silent congenital coronary artery anomalies

“…Identification is particularly important for children undergoing cardiopulmonary bypass. Several case reports have documented catastrophic outcomes when an unrecognized anomalously coursing RCA was inadvertently crossclamped and/or cardioplegia was instilled below the site of coronary origin causing perioperative ischemia [22][23][24]. Six of the 53 cases with high RCA take-off and 2 of the 4 cases with high LCA take-off in our series ultimately required surgery for incidentally associated congenital heart disease, underscoring the importance of rigorous preoperative screening for this anomaly.…”

High Takeoff of the Right Coronary Artery Associated with Ventricular Septal Defect, Right Aortic Arch, and Bridging Bronchus

“…High takeoff of the RCA, as in our case, is uncommon. Although this anomaly can be detected occasionally by coronary angiography, contrast‐enhanced computed tomography, or echocardiography, it is usually an incidental finding during surgery or autopsy …”

Anomalous “High Take‐Off” of the right coronary artery evaluated by coronary CT angiography

“…The main concern with a “high take‐off” of the RCA is decreased coronary perfusion leading to symptoms of myocardial ischemia, sudden death, or syncope, usually more pronounced on exertion []. A high RCA take‐off above its cusp may be associated with hypoplastic orifice, intimal hyperplasia, transient compression between the great arteries by spasm, and dilatation of the right ventricular infundibulum [7].…”

“…Congenital coronary artery anomalies occur with an incidence of ∼1% . The right coronary artery (RCA) is the most common anomalous artery but an abnormally “high take‐off” of the RCA ostium outside and above the sinuses of valsalva is “extremely rare” and is usually found unexpectedly during cardiac surgery or cardiac catheterization []. “High take‐off” refers to origin of either the right or left coronary artery above the junctional zone between its sinus and the tubular part of the ascending aorta .…”