Origin of anterior descending branch of left coronary artery from pulmonary trunk.

Probst, Paul; Pachinger, Otmar; Koller, H; Niederberger, M; Kaindl, F

doi:10.1136/hrt.38.5.523

Cited by 17 publications

(4 citation statements)

References 9 publications

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“…The vascularization of the RV can also reflect numerous variations in coronary artery origin, tract and distribution. Some can interfere with surgical reconstruction, especially major arterial branches crossing the infundibulum: an aberrant right coronary artery from the pulmonary trunk (Winner et al, ), abnormal origin of the coronary arteries from the pulmonary trunk (Ochos‐Ramirez et al, ), origin of the anterior interventricular artery from the pulmonary trunk (Prost et al ), origin of the left main coronary artery from the right aortic sinus and preinfundibular course, origin of the anterior (or accessory) interventricular artery from the right coronary artery or the right aortic sinus (Canga et al, ), single coronary artery with origin in the left aortic sinus, and a preinfundibular course of the right coronary artery. The numerous coronary arterial variations in congenitally malformed hearts are not discussed in this article.…”

Section: Vascularization Of the Right Ventricle And Right Ventricularmentioning

confidence: 99%

The clinical anatomy of the right ventricle

Mureşian

2014

Clinical Anatomy

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Because the systemic and pulmonary circulations are arranged in series, the right and left ventricles of the human heart have similar stroke volumes (with only minute beat-to-beat changes). Besides propelling the same volume of blood through the corresponding circulations, the two ventricles also share common structures such as the pericardium, the interventricular septum and the coronary arteries and veins-all of which complete the dynamic and integrated picture of the human heart. However, there are marked differences between the left and right ventricles as each is adapted to separate and dissimilar vascular beds, including particular reactivity to stress, hormones, and drugs. Of the two, the right ventricle (RV) has so far been either more difficult to approach from the diagnostic point of view or even overlooked, while the left ventricle (LV) has been considered the main pump, and diagnostic and therapeutic measures have been considered to apply equally to the LV and RV. This review article presents an update, portraying the RV from the clinical anatomical point of view, and endeavors to underscore the main particulars of the RV with clinical and surgical applications.

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Section: Vascularization Of the Right Ventricle And Right Ventricularmentioning

confidence: 99%

The clinical anatomy of the right ventricle

Mureşian

2014

Clinical Anatomy

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“…Since the left aortic sinus of Valsalva is in closer proximity to the septum of the truncus than to the right sinus [3], a far smaller displacement of the left coronary artery anlage will cause the left coronary artery ostium to fall within the pulmonary artery . Abrikossoff's theory, however, fails to explain those cases in which an accessory (third) coronary artery [6,27], or only one branch of the left coronary artery [1, 12,14,30,40,44], arises from the pulmonary artery . The theory also fails to explain why the relative size of the pulmonary artery, aorta, and their valves has not been found to be altered by displacement of the septum .…”

Section: Discussion Clinical Featuresmentioning

confidence: 98%

“…Rarer varieties of partial origin of the coronary arterial system from the pulmonary artery (PA) include origin of an accessory (third) artery from the PA, while the right and left coronary arteries arise normally from the aorta [6,27], origin of the left anterior descending coronary artery from the PA [14,40,44], and origin of the left circumflex coronary artery from the PA [4,30] . TCAPA is the rarest with only 21 cases having been previously reported (Tables I and 2) .…”

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confidence: 99%

Total anomalous origin of the coronary arteries from the pulmonary artery

et al. 1986

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The clinicopathologic features of four patients with total anomalous origin of the coronary arteries from the pulmonary artery (TCAPA) are presented and compared with 21 previously reported cases. Patients with TCAPA usually present with left ventricular heart failure, angina, or associated cardiovascular anomalies. Of the 19 patients in whom a clinical history was available, 16 were symptomatic before three days of age. All patients died with 60% dying before two weeks of age. Longer survival was associated with additional cardiovascular anomalies that increased pulmonary arterial perfusion pressure, oxygen saturation, or both. Seventeen (68%) patients had additional cardiovascular anomalies, most commonly atrial (nine cases) or ventricular (eight cases) septal defects and tetralogy of Fallot or other variants of pulmonary atresia (four cases). Only five (22%) of 23 had noncardiovascular anomalies. The coronary arteries arose equally from either one ostium or from two, and the number of ostia was not related to either anomalous coronary artery distribution or to the presence of additional cardiovascular anomalies. Cardiomegaly was present in 56% of cases and the majority of patients had myocardial fibrosis or infarction. Embryology is reviewed and evidence is presented to support the theory of involution-persistence of coronary artery anlagen as the pathogenetic mechanism of TCAPA.

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“…Origin of a coronary artery from the pulmonary artery is a rare anomaly affecting one in 300,000 live births, 15 % of whom may survive to adult life [ 11. This anomaly usually involves the left coronary artery (LCA), and much less commonly the right coronary artery (RCA). The anomalous origin of one subdivision of the LCA is exceedingly rare, with only one reported case each of the left anterior descending branch (LAD) and the circumflex branch [2,3]. We report the first case of the origin of the anterior descending branch of the LCA from the pulmonary artery to undergo surgical correction and 2-year postoperative angiographic study.…”

Section: Introductionmentioning

confidence: 97%

Anomalous origin of the left anterior descending coronary artery from the pulmonary artery: Surgical correction in an adult

Singh

Taylor

1983

Cathet. Cardiovasc. Diagn.

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A 45-year-old female with severe anginal symptoms was found to have anomalous origin of the anterior descending branch of the left coronary artery (LCA) from the pulmonary artery. Proximal ligation and anastomosis with aortocoronary saphenous vein graft (SVG) were performed. There was complete relief of symptoms. Two-year postoperative angiography revealed a patent SVG with excellent flow, normalization of the caliber of the right and left circumflex coronary arteries with complete regression of collaterals, and improved left ventricular function.

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Origin of anterior descending branch of left coronary artery from pulmonary trunk.

Cited by 17 publications

References 9 publications

The clinical anatomy of the right ventricle

The clinical anatomy of the right ventricle

Total anomalous origin of the coronary arteries from the pulmonary artery

Anomalous origin of the left anterior descending coronary artery from the pulmonary artery: Surgical correction in an adult

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