Origin of the left coronary artery from the right pulmonary artery

Abstract

Origin of the left coronary artery from the right pulmonary artery has rarely been documented. This is the first such case in a heart with an intact ventricular septum and paraductal coarctation of the aorta. Although an antemortem diagnosis was made and the anomalous left coronary artery was ligated, the patient, a 3 1/2 month old infant, died 1 day after surgery. Autopsy confirmed the diagnosis, but revealed that the left coronary artery was dominant. It is believed that the fatal outcome in the infant was, in part, due to the dominance of the left coronary artery and the effects of the coarctation on the already ischemic left ventricle.

Anomalous origin of the left coronary artery from the right pulmonary artery with intramural aortic trajectory. Clinicosurgical diagnostic implications

“…AOLCAPA is rarely associated with other cardiac defects, except when the origin is the RPA, a very rare anatomical situation. Of the 20 cases of AOLCARPA reported in the literature [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (table I), 14 had associated defects [3][4][5][8][9][10]13,14,16,[18][19][20][21] , half of which were coarctation of the aorta 5,8,10,13,20 . Interventricular septal defect 4,14 and tetralogy of Fallot 3,21 were also observed.…”

“…AOLCAPA is rarely associated with other congenital defects, unless the right pulmonary artery (RPA) takes part in the anomaly. The presence of associated defects in 70% of the 20 cases of origin of the left coronary artery from the RPA reported in the literature is well known [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (table I).…”

An unusual anomalous course of a coronary artery from the pulmonary trunk, coexisting with congenital mitral stenosis and aortic coarctation

“…A high origin, as in our case, or origin from a major branch of the pulmonary trunk is rare. 7 In these cases, the proximal main stem of the coronary artery is usually long and unencumbered until it enters the left atrioventricular groove underneath the left atrial appendage. In contrast, the proximal course of the anomalous artery in our case passed freely over the left atrial appendage, then through the atrial musculature before entering the atrioventricular groove.…”