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Related Experiment Video

Updated: Jun 12, 2026

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Intracavitary right coronary artery.

Jason G Andrade¹, Brett G Heilbron, Jonathon A Leipsic

¹Division of Cardiology, St. Paul's Hospital, Vancouver, BC, Canada. jasonandrade@shaw.ca

The Canadian Journal of Cardiology

|June 16, 2010

Summary

Congenital coronary artery anomalies, specifically intracavitary courses, are rare but pose significant challenges during cardiac procedures. Awareness is crucial for interventional cardiologists and surgeons to prevent inadvertent arterial disruption.

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Area of Science:

Cardiology
Anatomical Pathology

Background:

Congenital coronary artery anomalies are found in <1.3% of patients undergoing coronary angiography.
Most anomalies involve unusual origins or courses of major epicardial vessels.

Observation:

Intracavitary course of an intact epicardial coronary artery is exceptionally rare, with two described variants.
Historically detected during surgery or autopsy, advanced imaging now increases detection rates.

Findings:

While often clinically benign, these anomalies complicate invasive cardiac procedures.
Intramural or intracavitary courses present challenges in coronary artery bypass grafting and vessel localization.

Implications:

Interventional cardiologists and electrophysiologists must recognize this anomaly to avoid inadvertent disruption during procedures like angiography or pacemaker implantation.
Cardiothoracic surgeons, electrophysiologists, and invasive cardiologists require awareness for procedural risk assessment and planning.