Peng Teng1, Weidong Li1, Yiming Ni2. 1. Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Postal Address: 79#, Qingchun Road, Hangzhou, 310000, Zhejiang, China. 2. Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Postal Address: 79#, Qingchun Road, Hangzhou, 310000, Zhejiang, China. 1183020@zju.edu.cn.
Abstract
BACKGROUND: Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital heart disease affecting about 0.002% of the population. Knowledge of ARCAPA is almost collected from case reports. The aim of this study was to provide a rare case to better understand this rare congenital coronary anomaly. CASE PRESENTATION: We report a rare case of an 18-year-old male who was initially referred because of heart murmur. Dilated and tortuous coronary arteries were detected by echocardiography and congenital coronary anomaly was suggested. Further coronary CT angiography confirmed the diagnosis of ARCAPA. Although dual coronary system provides favorable long-term outcome, bypass surgery was considered technically difficult due to the huge mismatch of caliber between the right coronary artery and graft vessels. Eventually, simple right coronary artery ligation was performed. The patient was followed up for about 5 years without evidence of atherosclerosis or myocardial ischemia. CONCLUSIONS: ARCAPA presents as a rare congenital heart disease with variable clinical manifestations. Surgical treatment is highly recommended to re-establish dual coronary system and prevent further complications. To our best knowledge, only about 200 cases of ARCAPA has been reported.
BACKGROUND: Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital heart disease affecting about 0.002% of the population. Knowledge of ARCAPA is almost collected from case reports. The aim of this study was to provide a rare case to better understand this rare congenital coronary anomaly. CASE PRESENTATION: We report a rare case of an 18-year-old male who was initially referred because of heart murmur. Dilated and tortuous coronary arteries were detected by echocardiography and congenital coronary anomaly was suggested. Further coronary CT angiography confirmed the diagnosis of ARCAPA. Although dual coronary system provides favorable long-term outcome, bypass surgery was considered technically difficult due to the huge mismatch of caliber between the right coronary artery and graft vessels. Eventually, simple right coronary artery ligation was performed. The patient was followed up for about 5 years without evidence of atherosclerosis or myocardial ischemia. CONCLUSIONS: ARCAPA presents as a rare congenital heart disease with variable clinical manifestations. Surgical treatment is highly recommended to re-establish dual coronary system and prevent further complications. To our best knowledge, only about 200 cases of ARCAPA has been reported.
Authors: Anthony Azakie; Jennifer L Russell; Brian W McCrindle; Glen S Van Arsdell; Lee N Benson; John G Coles; William G Williams Journal: Ann Thorac Surg Date: 2003-05 Impact factor: 4.330
Authors: Timothy M Guenther; Elan A Sherazee; Andrew D Wisneski; Joshua D Gustafson; Curtis J Wozniak; Gary W Raff Journal: Ann Thorac Surg Date: 2020-03-07 Impact factor: 4.330