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Ann Thorac Surg 2008;85:675-677. doi:10.1016/j.athoracsur.2007.06.085
© 2008 The Society of Thoracic Surgeons
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Iki Adachi
Toshikatsu Yagihara
Ikuo Hagino
Toru Ishizaka
Junjiro Kobayashi
Soichiro Kitamura
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Unroofing Aortic Intramural Left Coronary Artery Arising From Right Pulmonary Artery

Iki Adachi, MD, Koji Kagisaki, MD*, Toshikatsu Yagihara, MD, Ikuo Hagino, MD, Toru Ishizaka, MD, Junjiro Kobayashi, MD, Soichiro Kitamura, MD

Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan

Accepted for publication June 28, 2007.

* Address correspondence to Dr Kagisaki, 5-7-1Fujishiro-dai, Suita, Osaka, 565-8565, Japan (Email: kagisaki{at}hsp.ncvc.go.jp).

We report an operative case of the anomalous origin of the left coronary artery from the right pulmonary artery with aortic intramural course. This particular anatomy was clearly identified with a preoperative angiogram. The restoration of the two-coronary system was accomplished by unroofing the intramural segment into the left sinus of Valsalva with encouraging midterm results. The details of this anatomical correction are described with a review of the literature.






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