Vascular aneurysm producing divided right atrium in a patient with pulmonary atresia and intact ventricular septum

2000 ◽  
Vol 10 (3) ◽  
pp. 281-285 ◽  
Author(s):  
John C. Wood ◽  
Miguel Reyes-Mugica ◽  
Gary Kopf
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Right Atrium ◽  
Pulmonary Atresia ◽  
Pulmonary Trunk ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Atrioventricular Groove ◽  
The Right

AbstractWe describe a patient with pulmonary atresia and intact ventricular septum in whom the right atrium was divided by a vascular aneurysm located in the right atrioventricular groove. We postulate that the structure represents an aneursymally dilated right coronary artery taking anomalous origin from the pulmonary trunk, with fistulous communication to the right atrium. We discuss the findings relative to concepts of development of the coronary arteries in normal hearts and in pulmonary atresia with an intact ventricular septum.

The prevalence of coronary arterial abnormalities in pulmonary atresia with intact ventricular septum and their influence on surgical results

2007 ◽  
Vol 17 (4) ◽  
pp. 387-396 ◽  
Author(s):  
A. Louise Calder ◽  
Charles R. Peebles ◽  
Christopher J. Occleshaw
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Coronary Arteries ◽  
Pulmonary Atresia ◽  
Left Ventricular ◽  
Ventricular Septum ◽  
Left Ventricular Myocardium ◽  
Intact Ventricular Septum ◽  
The Right

AbstractBackgroundThe relatively high mortality in patients with pulmonary atresia and intact ventricular septum may be related to the presence of significant coronary arterial anomalies. This retrospective review of cineangiocardiograms was undertaken to further elucidate the types and variety of such coronary arterial abnormalities, and to assess their effect on postoperative survival.Material and resultsDetails regarding coronary arterial anatomy and abnormalities were assessed in 116 patients. We noted the site and severity of lesions, and the presence of fistulous communications from the right ventricle to the coronary arteries, assessing the proportion of left ventricular myocardium affected by coronary arterial interruptions or significant stenoses, in other words, the amount dependent on coronary circulation from the right ventricle. We also measured diameters of the tricuspid and mitral valves. Fistulas were found in 87 patients (75%), interruptions of major coronary arteries in 40 patients (34%), lack of connections between the coronary arteries and the aorta in 18 patients (16%), and single origin of a coronary artery, with the right coronary artery arising from the left, in 6 patients (5%). We found increased mortality in 47 patients (40%) who had a right ventricular-dependent coronary arterial circulation. The presence of fistulas in itself was not associated with higher mortality, but the presence of coronary arterial interruptions (p = 0.05), and a higher myocardial score (p = 0.0009), were.ConclusionWe encountered a higher prevalence of both coronary arterial abnormalities and right ventricular-dependent circulation than previously reported. Awareness of the severity of the coronary arterial abnormalities should assist in planning treatment.

Anomalous origin and course of the coronary arteries

2010 ◽  
Vol 20 (S3) ◽  
pp. 20-25 ◽  
Author(s):  
Anthony Hlavacek ◽  
Marios Loukas ◽  
Diane Spicer ◽  
Robert H. Anderson
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Pulmonary Trunk ◽  
Main Stem ◽  
Anomalous Origin ◽  
Aortic Sinus ◽  
Atrioventricular Groove ◽  
The Right

AbstractIn the normal heart, the right and left coronary arteries arise from the aortic valvar sinuses adjacent to the pulmonary trunk. The right coronary artery then directly enters the right atrioventricular groove, whereas the main stem of the left coronary artery runs a short course before dividing to become the anterior interventricular and circumflex arteries. These arteries can have an anomalous origin from either the aorta or pulmonary trunk; their branches can have various anomalous origins relative to arterial pedicles. Other abnormal situations include myocardial bridging, abnormal communications, solitary coronary arteries, and duplicated arteries. Understanding of these variations is key to determining those anomalous patterns associated with sudden cardiac death. In the most common variant of an anomalous origin from the pulmonary trunk, the main stem of the left coronary artery arises from the sinus of the pulmonary trunk adjacent to the anticipated left coronary arterial aortic sinus. The artery can, however, arise from a pulmonary artery, or the right coronary artery can have an anomalous pulmonary origin. The key feature in the anomalous aortic origin is the potential for squeezing of the artery, produced by either the so-called intramural origin from the aorta, or the passage of the abnormal artery between the aortic root and the subpulmonary infundibulum.

Further morphologic studies on hearts with pulmonary atresia and intact ventricular septum

1991 ◽  
Vol 1 (2) ◽  
pp. 105-113 ◽  
Author(s):  
Robert H. Anderson ◽  
Christine Anderson ◽  
James R. Zuberbuhler
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Tricuspid Valve ◽  
Coronary Arteries ◽  
Pulmonary Atresia ◽  
Outflow Tract ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Ventricular Cavity ◽  
The Right

SummaryAtresia of the outflow tract of the right ventricle in the presence of an intact ventricular septum poses major problems for surgical management. In the light of known problems, 43 autopsied hearts with this congenital abnormality were evaluated to note the arrangement of the myocardium and the cavity of the right ventricle, the state of the tricuspid valve, the precise substrate for pulmonary atresia, and the presence offistulous communications between the ventricular cavity and the coronary arteries. The specimens could be divided into two groups. The first group (38 hearts) had hypoplasia of the cavity of the right ventricle with mural hypertrophy while the second group (5 hearts) had a dilated right ventricular cavity with thinning of the wall. The larger group could be divided into two subgroups on the basis of the substrate for pulmonary atresia. Twenty hearts had muscular atresia of the right ventricular outflow tract and 18 had a potentially patent outflow tract blocked by an imperforate pulmonary valve. A comparison of these two subgroups revealed that mural hypertrophy and cavitary hypoplasia were more severe in hearts with muscular atresia. The tricuspid valve was hypoplastic and its leaflets were not dysplastic in this group but the leaflets were dysplastic in hearts with valvar pulmonary atresia. Fistulous communications between the ventricular cavity and the coronary arteries were only seen in the cases with muscular atresia. In this series, recognition of muscular pulmonary atresia would have identified those patients with the worst surgical prognosis.

The Ross procedure performed in the setting of congenitally bifoliate aortic valve with anomalous right coronary artery

2005 ◽  
Vol 15 (2) ◽  
pp. 213-215 ◽  
Author(s):  
Masayuki Morikawa ◽  
Ko Bando ◽  
Shinji Sato
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Ross Procedure ◽  
Aortic Sinus ◽  
Anomalous Artery ◽  
Atrioventricular Groove ◽  
The Right

We treated successfully using the Ross procedure a 14-year old with a congenitally stenotic bifoliate aortic valve associated with anomalous origin of the right coronary artery. The anomalous artery arose from the same aortic sinus that gave rise to the main stem of the left coronary artery, and reached the right atrioventricular groove by traversing the tissue plane between the aortic root and the subpulmonary infundibulum. Both coronary arteries were reimplanted using a single arterial button.

scholarly journals A Single Coronary Artery Originating from the Right Coronary Sinus with a Typical Course of the Right Coronary Artery and the Interarterial Course of the Left Main, Left Anterior Descending, and Left Circumflex as an Example of a Rare Case of High-Risk Coronary Anomaly

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 167
Author(s):  
Paweł Gać ◽  
Aleksandra Żórawik ◽  
Rafał Poręba
Keyword(s):  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Coronary Sinus ◽  
Cardiac Death ◽  
Rare Case ◽  
Pulmonary Trunk ◽  
Increased Risk ◽  
The Right

In the typical course of the coronary arteries, the right coronary artery comes from the right coronary sinus and descends in the right atrioventricular groove. The left coronary artery trunk begins from the left coronary sinus. It crosses the pulmonary trunk and divides into left anterior descending and left circumflex arteries. Anatomical differences of the coronary arteries can be observed in 0.3–5.6% of the population. The interarterial course of coronary branches between the aorta and the pulmonary trunk is a malignant anomaly of the coronary arteries. Such abnormalities have been associated with an increased risk of sudden cardiac death. We present a rare case of coronary arteries anomaly involving the presence of a single right coronary artery and the interarterial course of its atypical branches documented by computed tomography angiography (CTA). In summary, the accurate assessment of the anatomical topography of coronary anomalies, possible in CTA, is necessary in the analysis of the risk of sudden cardiac death and its prevention.

Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children

2007 ◽  
Vol 17 (S4) ◽  
pp. 56-67 ◽  
Author(s):  
Alan H. Friedman ◽  
Mark A. Fogel ◽  
Paul Stephens ◽  
Jeffrey C. Hellinger ◽  
David G. Nykanen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Functional Assessment ◽  
Left Coronary Artery ◽  
Left Ventricular ◽  
Pulmonary Trunk ◽  
Anomalous Origin ◽  
Sinus Of Valsalva ◽  
The Right

AbstractThe coronary arteries, the vessels through which both substrate and oxygen are provided to the cardiac muscle, normally arise from paired stems, right and left, each arising from a separate and distinct sinus of the aortic valve. The right coronary artery runs through the right atrioventricular groove, terminating in the majority of instances in the inferior interventricular groove. The main stem of the left coronary artery bifurcates into the anterior descending, or interventricular, and the circumflex branches. Origin of the anterior descending and circumflex arteries from separate orifices from the left sinus of Valsalva occurs in about 1% of the population, while it is also frequent to find the infundibular artery arising as a separate branch from the right sinus of Valsalva.Anomalies of the coronary arteries can result from rudimentary persistence of an embryologic coronary arterial structure, failure of normal development or normal atrophy as part of development, or misplacement of connection of a an otherwise normal coronary artery. Anomalies, therefore, can be summarized in terms of abnormal origin or course, abnormal number of coronary arteries, lack of patency of the orifice of coronary artery, or abnormal connections of the arteries.Anomalous origin of the left coronary artery from the pulmonary trunk occurs with an incidence of approximately 1 in 300,000 children. The degree of left ventricular dysfunction produced likely relates to the development of collateral vessels that arise from the right coronary artery, and provide flow into the left system. Anomalous origin of either the right or the left coronary artery from the opposite sinus of Valsalva can be relatively innocuous, but if the anomalous artery takes an interarterial course between the pulmonary trunk and the aorta, this can underlie sudden death, almost invariably during or immediately following strenuous exercise or competitive sporting events. Distal anomalies of the coronary arteries most commonly involve abnormal connections, or fistulas, between the right or left coronary arterial systems and a chamber or vessel.We discuss the current techniques available for imaging these various lesions, along with their functional assessment, concluding with a summary of current strategies for management.

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