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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Advantage of vein grafts for anomalous origin of a right coronary artery

Rei Kansaku1, Hirofumi Saitoh, Shoji Eguchi

  • 1Department of Cardiovascular Surgery, Niigata Kobari Hospital, 3-27-11 Kobari, Nishi-ku, Niigata, Niigata 950-2022, Japan. kansaku-ths@umin.ac.jp

General Thoracic and Cardiovascular Surgery
|March 13, 2009
PubMed

Insights

Anomalous right coronary artery compression caused chest pain. Coronary artery bypass grafting successfully relieved symptoms and restored blood flow, offering a reliable treatment for this rare condition.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Diagnostic Imaging

Background:

  • Anomalous origin of the coronary artery is a rare congenital heart defect.
  • Intermittent compression of the anomalous right coronary artery can lead to myocardial ischemia and chest pain.

Observation:

  • A 66-year-old male presented with chest pain attributed to anomalous origin of the right coronary artery.
  • Coronary angiography and multidetector computed tomography revealed intermittent compression of the proximal right coronary artery.

Findings:

  • Coronary artery bypass grafting (CABG) was chosen over percutaneous coronary intervention due to the high flow in the right coronary artery, utilizing a vein graft to prevent competitive flow.
  • Postoperative angiography confirmed unobstructed flow in both the native artery and the vein graft one year after surgery.

Implications:

  • CABG is an effective surgical option for managing symptomatic anomalous coronary artery origins causing myocardial ischemia.
  • Successful revascularization led to complete resolution of chest pain and myocardial ischemia.

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