Anomalous origin of circumflex coronary artery arising from proximal right coronary artery

We present a 55 year old man that was admitted to our Institution because of anginal chest pain. Transthoracic echocardiogram was normal. Coronary angiography showed three vessels disease and an anomalous circumflex artery arising from right proximal coronary artery. By-pass surgery was successfully performed.     

Anomalous origin of circumflex coronary artery from right pulmonary artery associated with atrial septal defect

We describe a 4-year-old girl with anomalous origin of the left circumflex coronary artery from the right pulmonary artery and large atrial septal defect. This is the first reported case of such association. Surgical reimplantation of the anomalous left circumflex coronary artery to the aorta and atrial septal defect surgical closure was performed, with no postoperative complications.     

Anomalous origin of the right coronary artery arising from the circumflex artery

A case of anomalous origin of the right coronary artery discovered among 3100 selective coronary arteriograms is described. This artery was arising from the circumflex artery. The position, distribution, and configuration of this coronary artery was as a normal right coronary artery, except that its origin was in the peripheral segment of the circumflex artery. This anomalous origin is very rare and seems not to give rise to any clinical significance.     

Anomalous connection of left circumflex artery to pulmonary artery

A 52-year-old woman was evaluated for chest discomfort and dyspnea on exertion. Coronary angiography demonstrated an anomalous connection between the left circumflex artery and the right pulmonary artery. Successful repair was achieved under cardiopulmonary bypass, and the patient became completely symptom-free.     

Anomalous left coronary artery from non-facing pulmonary sinus

A case of anomalous left coronary artery originating from the non-facing pulmonary sinus, located at the most distal position from the aorta, is described. An intrapulmonary tunnel was created without causing undue stenosis or kinking. The Takeuchi procedure is considered to be a useful surgical technique when the origin of the anomalous left coronary artery is far from the aorta.     

Anomalous origin of left coronary artery from pulmonary artery.

An anomalous origin of the left coronary artery from the pulmonary artery in a 26-year-old man was corrected by the ligation of the artery at its anomalous origin, followed by the construction of an aortocoronary bypass with a venous graft. The flow of blood to the myocardium was measured for the purpose of comparing the effect of the bypass method with that of the ligation method. The result suggested that the bypass method provided a greater flow of blood to the myocardium than did ligation alone.     

Anomalous right coronary artery originating from the distal left circumflex artery: single coronary artery with choronic atrial fibrillation

This report describes a patient with a single coronary artery in whom the right coronary artery originated from the distal left circumflex artery. Single coronary artery is a rare congenital anomaly of the coronary circulation which is often associated with other congenital cardiac malformations. This anomaly is thought to be clinically significant especially in patients with atrial fibrillation, although no other associated cardiac anomaly was detected.     

Anomalous origin of left coronary artery from pulmonary artery associated with pulmonary hypertension

This is a report on a 10-year-old child with anomalous origin of left coronary artery (LCA) from pulmonary artery (ALCAPA), severe pulmonary hypertension (PH), old myocardial infarction and poor intercoronary collateralization. It discusses the echocardiographic pitfalls in this particular setting and introduces a new echocardiographic view (posterior pulmonary cusp view) for visualization of the anomalous origin of LCA from the posterior pulmonary cusp (PC) in patients with ALCAPA from the PC of the pulmonary artery. We describe three echocardiographic pitfalls that can mislead the echocardiographer and two helpful hints that guide the clinician to the correct diagnosis.The survival of this child shows that limited size of left ventricular myocardial infarction and severe mitral regurgitation in early infancy can result in a life-saving pulmonary hypertension which preserves viability and function of left ventricle despite lack of intercoronary collateral arteries. After one year follow-up, she is doing well on medical treatment.     

Anomalous origin of left coronary artery from pulmonary artery in adults

Various techniques have been described for management of anomalous origin of the left coronary artery from the pulmonary artery presenting in adults. Three patients, 1 male and 2 females, aged 27-37 years, underwent transpulmonary pericardial patch closure with concomitant left internal thoracic artery anastomosis to the left anterior descending artery, under standard cardiopulmonary bypass, thus creating a two-coronary system. One patient had concomitant mitral valve repair. All 3 survived the operation. Postoperative angiography in 2 patients revealed good antegrade flow with decreased collaterals in one and competitive inhibition with increased collaterals in the other. This procedure is considered to be the safest and simplest in this subset of patients.     

Anomalous origin of the right coronary artery from the pulmonary artery

Two patients with an anomalous right coronary artery arising from the pulmonary artery are presented. The first patient was asymptomatic and had a continuous murmur. The correct diagnosis was established by cardiac catheterization and selective angiography. There was a moderate sized shunt from the dilated left anterior descending coronary artery to the right coronary artery, which arose from the main pulmonary artery. The second patient was also asymptomatic but died several days after a sudden cardiorespiratory arrest. On postmortem examination she was demonstrated to have anomalous origin of the right coronary artery from the pulmonary artery. The left coronary artery was completely occluded at the orifice by a thrombus, and microscopic examination demonstrated evidence of both acute and chronic left ventricular ischemia and infarction. The pathophysiologic alterations and potential danger to patients with this anomaly are discussed.