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Ann Thorac Surg 1999;68:292-293
© 1999 The Society of Thoracic Surgeons

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Correspondence

Anomalous origin of the right coronary artery from the pulmonary artery

^a Division of Cardiovascular Surgery, Paulista School of Medicine, Federal University of Sao Paulo, Al dos Anapurus, 1580 Apt 73-Moema, CEP: 04087-005 Sao Paulo, Brazil
^b Albert Einstein Hospital, Av Albert Einstein, 627, Morumbi CEP: 05651-901, Sao Paulo, Brazil

e-mail: miguel{at}bes-way.com.br.

To the Editor

In a recent article in these annals, Radke and colleagues [1] reported the hemodynamic pre and postoperative study of a 60-year-old woman with a diagnoses of an anomalous origin of the right coronary artery (RCA) from the pulmonary trunk. When the patient was referred to the hospital in 1996, she reported progressive dyspnea during exercise, chronic fatigue, and angina on exertion.

Associated congenital cardiac defects are reported in 40% [1] of the patients with abnormal origin of the RCA and the diagnosis is established on hemodynamic study or during the operative procedure.

Recently, a 6-year-old boy was admitted to an outpatient clinic with onset of progressive dyspnea and systolic murmur. The clinical and echocardiographic diagnosis was ventricular septal defect (VSD) with moderate pulmonary hypertension.

The preoperative cardiac catheterization performed in our institution demonstrated anomalous origin of the right coronary artery from the pulmonary trunk associated with subaortic VSD.

The surgical correction was performed on March 5, 1996. At surgery it was observed that the RCA originated from the right aspect of the pulmonary trunk.

The repair was easily accomplished with moderate hypothermia and cardioplegic cardiac arrest. The VSD was closed and RCA, with a cuff of pulmonary wall, was transferred to the ascending aorta.

A week later, a postoperative cardiac catheterization showed absence of left to right shunt and patent RCA.

As described here, we published this rare case in the Texas Heart Institute Journal, 1997;24:226–9. Our patient is the 58th reported case, 24th case with less than 10 years, 31st case diagnosed during angiography, and the first case with isolated VSD.

References

1. Radke P.W., Messmer B.J., Haager P.K., Klues H.G. Anomalous origin of the right coronary artery. Ann Thorac Surg 1998;66:1444-1449.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Michael R. Smith Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Maluf, M. A. Articles by Rati, M. Search for Related Content PubMed Articles by Maluf, M. A. Articles by Rati, M.