An incidental encounter of a rare high take-off right coronary artery: A case report
Xicheng Deng1, Peng Huang, Wenjuan Chen
1Heart Center Department of Ultrasound and Echocardiography, Hunan Children's Hospital, Hunan, China Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
Insights
A rare high take-off coronary artery anomaly was incidentally discovered during surgery for an atrial septal defect in a pediatric patient. Early detection through echocardiography is crucial for preventing surgical complications and ensuring patient safety.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Defects
Background:
- High take-off of the coronary arteries is a rare anomaly, often associated with congenital heart defects.
- It poses a risk for sudden cardiac death and intraoperative complications during cardiac surgeries.
- Early identification is vital for surgical planning and patient safety.
Rationale:
High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects.
Patient Concerns:
A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography. He was referred to our institution for elective surgery.
Diagnoses:
The preoperative echocardiogram confirmed the presence of an atrial septal defect, and during the surgical procedure, a high take-off right coronary artery was found.
Interventions:
The atrial septal defect was closed surgically, and care was taken to avoid clamping the anomalous right coronary artery when placing the aortic cross-clamp.
Outcomes:
Postoperative echocardiogram verified the presence of the high take-off right coronary artery and a satisfactory repair of the atrial septal defect. The postoperative course was uneventful, and the patient was discharged on postoperative day 5.
Lessons:
This case suggests that it is critical to perform echocardiography to assess the anatomy of the coronary arteries, especially in pediatric cardiac patients. In addition, multi-detector computed tomography may be considered if appropriate. Care should be taken to assess the coronary anatomy for anomalies during interventional therapy or surgery, especially in congenital cases.
More Related Videos
08:42Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
07:02Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
Published on: September 9, 2020
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:21Cardiac Catheterization II: Right Heart Catheterization
01:30Coronary Artery Disease I: Introduction
01:30Coronary Artery Disease III: Clinical Manifestations
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...