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

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Correspondence

Reply

^a Medical Clinic I and Department of Cardiothoracic Surgery, RWTH University Hospital, Pauwelsstrasse 30, D-52057, Aachen, Germany

To the Editor

Anomalous origin of the right coronary artery from the main pulmonary artery is a rare congenital cardiac malformation with a potentially malign course of the disease. We recently reported a patient with anomalous origin of the right coronary artery from the pulmonary trunk in whom a complete hemodynamic assessment including intracoronary Doppler flow measurements was performed before and after surgical reimplantation [1]. The clinical, morphologic and functional results obtained fourteen weeks after reinsertion of the aberrant vessel into the ascending aorta very strongly supported the concept of anatomically corrective surgery.

This case report was followed by a review of the literature including 57 previously reported cases. Despite an extensive MEDLINE literature search we have to apologize for not identifying a recent article by Maluf and associates [2]. This interesting case report describes a patient with anomalous origin of the right coronary artery from the pulmonary artery in association with a ventricular septal defect (VSD) in whom a surgical reinsertion of the coronary vessel and closure of the VSD were performed. Two weeks later an early postoperative angiography was performed documenting antegrade flow in the right coronary artery and persistent closure of the VSD.

In summary, the report by Maluf and associates supports the observation that associated congenital cardiac defects are relatively often (> 40%) found in patients with anomalous origin of the right coronary artery from the main pulmonary artery. In addition, the therapeutic concept of anatomical corrective surgery in this malformation is further strengthened.

References

1. Radke P.W., Messmer B.J., Haager P.K., Klues H.K. Anomalous origin of the right coronary artery. Ann Thorac Surg 1998;66:1444-1449.[Abstract/Free Full Text]
2. Maluf M.A., Smith M., Abellan D.M., et al. Anomalous origin of the right coronary artery from the pulmonary artery in association with a ventricular septal defect. Tex Heart Inst J 1997;24:226-229.[Medline]

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): Bruno J. Messmer Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Radke, P. W. Articles by Messmer, B. J. Search for Related Content PubMed Articles by Radke, P. W. Articles by Messmer, B. J. Related Collections Related Article