DOI: http://dx.doi.org/10.18203/2349-2902.isj20182001

Surgical implications of anomalous right coronary artery from left sinus of valsalva

Jai Bhagwan, Anubhav Gupta, Sankalp ., Sudesh Kumar, Vijay Kumar Gupta

Abstract


Anomalous origin of right coronary artery (RCA) from left coronary sinus (LCS) can pose difficult challenge in patients undergoing cardiac surgery. Authors present a 31 years old male patient diagnosed with Rheumatic heart disease, severe mitral stenosis with moderate aortic regurgitation. Patient underwent Double valve replacement and anomalous RCA was diagnosed intraoperatively. Authors recommend that origins of coronary arteries must be echocardiographically evaluated in all patients undergoing valve surgery, especially when coronary angiography is not indicated/planned.


Keywords


Anomalous RCA, Anomalous coronaries, Double valve replacement

Full Text:

PDF

References


White NK, Edwards JE. Anomalies of the coronary arteries. Report of four cases. Arch Pathol. 1948;45:766-71.

Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiiovasc Diagn. 1990;21:28-40.

Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation. 2002;105:2449-54.

Cheitlin MD, De Castro CM, McAllister HA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva, a not-so-minor congenital anomaly. Circulation. 1974;50:780-7.

Roberts WC, Siegel RJ, Zipes DP. Origin of the right coronary artery from the left sinus of Valsalva and its functional consequences: analysis of 10 necropsy patients. Am J Cardiol. 1982;49:863-8.

Kragel AH, Roberts WC. Anomalous origin of either the right or left main coronary artery from the aorta with subsequent coursing between aorta and pulmonary trunk: analysis of 32 necropsy cases. Am J Cardiol. 1988;62:771-7.

Nicholas TK, Blackstone EH, Hanley F,. Kirklin JK, Kirklin/Barratt-Boyes. Cardiac Surgery, fourth edition. Congenital anomalies of the coronary Arteries, 2013;478.

Juredidini SB, Marino CJ, Singh GK. Aberrant coronary artery: a reliable echocardiographic screening method. J Am Soc Echocardiogr 2003;16:756-63.

Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congential Heart Disease). J Am Coll Cardiol. 2008;52:e143-263.