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.

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.

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.

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.

Noninvasive methods of accurately diagnosing in children anomalous origin of the left coronary artery from the pulmonary trunk

2009 ◽  
Vol 19 (5) ◽  
pp. 474-481 ◽  
Author(s):  
Kuang-Jen Chien ◽  
Ta-Cheng Huang ◽  
Kai-Sheng Hsieh ◽  
Chu-Chuan Lin ◽  
Ken-Pen Weng ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiac Catheterization ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Pulmonary Trunk ◽  
Anomalous Origin ◽  
Noninvasive Methods ◽  
Echocardiographic Examination ◽  
Collateral Vessels ◽  
The Right

AbstractBackgroundAnomalous origin of the left coronary artery from the pulmonary trunk is a rare congenital heart defect. Cardiac catheterization remains the standard means of diagnosis. Our purpose in this study is to emphasize the importance of assessing the electrocardiogram when making the diagnosis, in addition to taking note of transthoracic echocardiographic findings. We also analyzed the sensitivity of each parameter under investigation.Methods and ResultsBetween June, 1999, and March, 2007, we studied 9 patients, 6 males and 3 females, with a mean age of 3.02 years, in whom anomalous origin of the left coronary artery from the pulmonary trunk was suspected subsequent to transthoracic echocardiographic examination. We examined their electrocardiograms, and undertook cardiac catheterization. In all patients, the transthoracic echocardiogram had shown retrograde flow into the pulmonary trunk, with the left coronary artery arising from pulmonary trunk, along with a dilated right coronary artery, or intercoronary collateral vessels. In 8 patients, the electrocardiogram showed deep Q wave in leads I and aVL, with depression of the ST segments over lead V4 through 6, or inversion of the T waves in leads I, II, and aVL. In the remaining patient, the electrocardiogram showed incomplete right bundle branch block. Later, cardiac catheterization confirmed the diagnosis in 8 patients, but the other patient was shown to have the right coronary artery arising from the pulmonary trunk.ConclusionsBy combining transthoracic echocardiography with study of the electrocardiogram, it is possible to provide accurate evaluation of anomalous origin of the left coronary artery from the pulmonary trunk.

Anomalous left coronary artery from the non-adjacent sinus of the pulmonary trunk

2003 ◽  
Vol 13 (1) ◽  
pp. 95-97
Author(s):  
Bhava R. J. Kannan ◽  
Sivadasan R. Anil ◽  
R. Krishna Kumar
Keyword(s):  
Coronary Artery ◽  
Rare Variant ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Pulmonary Trunk ◽  
Anomalous Origin ◽  
Anomalous Left Coronary Artery ◽  
The Right ◽  
Anomalous Left Coronary

We report a rare variant of anomalous origin of the left coronary artery from the non-adjacent sinus of the pulmonary trunk. The patient also had the right coronary artery arising from the non-facing sinus of the aorta.

A CADAVERIC STUDY ON CORONARY ARTERY VARIATIONS AND ITS CLINICAL `SIGNIFICANCE

2021 ◽  
pp. 20-22
Author(s):  
Sony Jhansi Priya ◽  
Sangeetha A ◽  
M. Sai Krishna
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Left Coronary Artery ◽  
Coronary Vessels ◽  
Average Diameter ◽  
Cadaveric Study ◽  
Aortic Sinus ◽  
Clinical Procedures ◽  
Human Cadavers ◽  
The Right

Coronary artery variations are one of the commonest variations observed during clinical procedures. Normally, there are two main coronary arteries, the right coronary artery (RCA), left coronary artery (LCA).Left coronary artery gives two important branches left circumex artery (LCX) and left anterior descending (LAD) arteries. Knowledge about the coronary vessels and its variations are essential to clinicians to prevent untoward injury of vessels during any procedures. To study the morphology and variations of coronar Aim: y arteries by dissection. Materials and Methods: The present study was a cadaveric study which was conducted on 50 hearts obtained from adult human cadavers. Coronary arteries were dissected to see the origin, course and variations. The data was entered in Microsoft excel sheet and expressed in percentage. The Right Results: coronary artery branched out from the right aortic sinus and had an average diameter of 3.5mm. The left coronary artery arouse from left aortic sinus and had an average diameter of 4mm. LMCA divided into two branches in 60 percent, three branches in 30 percent and four branches in 06 percent of the hearts and direct branches from left aortic sinuus in 4 percent hearts.Based on the origin of Posterior descending or interventricular artery, Right dominance was observed in 68 percent, left dominance in 26 percent, and equal dominance in 06 percent of the hearts. Conclusion: Knowledge about the variations of coronary vessels is a prerequisite for clinicians to perform interventions of coronary vessels.

Anomalous origin of the right coronary artery from the pulmonary trunk, echocardiographic and colour Doppler features

1997 ◽  
Vol 7 (4) ◽  
pp. 438-441
Author(s):  
Amanda J. Barlow ◽  
George G.S. Sandor ◽  
Jacques G. Le Blanc
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Pulmonary Trunk ◽  
Anomalous Origin ◽  
Colour Doppler ◽  
Rare Congenital Anomaly ◽  
Nuclear Angiography ◽  
The Right ◽  
Echocardiographic Findings ◽  
Angiographic Findings

AbstractAnomalous origin of the right coronary artery from the pulmonary trunk is a rare congenital anomaly. Diagnosis is usually made at autopsy or incidentally in asymptomatic adults, but cardiopul-monary arrest and sudden death have been reported. The angiographic findings have been well described but the echocardiographic findings are less well documented.This report describes the echo and colour Doppler findings in a 3-year-old child with an anomalous right coronary artery arising from the pulmonary trunk, as well as observations on myocardial perfusion demonstrated by nuclear angiography.

Anomalous origin of the right coronary artery from the pulmonary trunk

1998 ◽  
Vol 8 (2) ◽  
pp. 262-264
Author(s):  
Fátima Ferreira Pinto ◽  
Sashicanta Kaku ◽  
José Sousa Ramos
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Pulmonary Trunk ◽  
Anomalous Origin ◽  
The Right

SummaryWe report a case of anomalous origin of the coronary artery from the pulmonary trunk. The lesion was discovered in an eleven-month-old asymptomatic boy because of a continuous murmur.

Sign in / Sign up

Export Citation Format

Share Document