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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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Setting things "right": right internal mammary artery on anomalous right coronary artery - a case report

M D'Abramo1, S Saltarocchi1, W Saade1

  • 1Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, Rome, Italy.

The Journal of International Medical Research
|November 5, 2021
PubMed

Insights

Anomalous aortic origin of a coronary artery (AAOCA) is a rare condition. Surgical revascularization using the right internal mammary artery (RIMA) offers a safe and effective treatment alternative.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart defect.
  • It can lead to myocardial infarction, arrhythmias, and sudden cardiac death (SCD).
  • Current treatment guidelines for AAOCA are lacking.

Observation:

  • A 47-year-old woman presented with an anomalous right coronary artery (RCA) originating from the left sinus of Valsalva.
  • The RCA had an interarterial course between the aorta and pulmonary trunk.
  • A portion of the RCA had an intramural course.

Findings:

  • The patient underwent revascularization using the right internal mammary artery (RIMA).
  • The RIMA was anastomosed to the anomalous RCA, and the RCA was ligated proximally.
  • This surgical approach effectively addressed the anomalous coronary artery course.

Implications:

  • This RIMA grafting technique is a safe, fast, and viable alternative to traditional coronary reconstruction for AAOCA.
  • It highlights a practical surgical solution for managing this rare anomaly.
  • Further research may explore its long-term efficacy and broader application in AAOCA cases.

Keywords:
Anomalous coronary arteryaortacardiac surgerycongenital heart diseasecoronary artery bypass graftinternal mammary artery

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