Left main coronary artery atresia complicated by fistulae between the left anterior descending artery and the right ventricle

This case describes a 60-year-old man with congenital atresia of the left main coronary artery (LMCA), with fistulae between the left anterior descending artery (LAD) and the right ventricle (RV). This was detected at coronary CT. To our knowledge, this is the first reported case of congenital atresia of the LMCA in conjunction with fistulae between the LAD and RV. The patient remains asymptomatic at a 2-year follow-up. No treatment has been recommended. Coronary artery anomalies are rare. Although usually asymptomatic, they can present with symptoms varying from angina to sudden death. Identification and accurate description of coronary artery anomalies are vital in assessing the risk of associated adverse events.

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Ligation of a Fistula between the Left Main Coronary Artery and Both the Pulmonary Artery and the Right Ventricle

The Heart Surgery Forum ◽

10.1532/hsf98.20111083 ◽

2012 ◽

Vol 15 (2) ◽

pp. 119 ◽

Cited By ~ 2

Author(s):

I. Halil Algin ◽

Aytekin Yesilay ◽

N. Murat Akcar

Keyword(s):

Cardiopulmonary Bypass ◽

Coronary Artery ◽

Pulmonary Artery ◽

Right Ventricle ◽

Left Main Coronary Artery ◽

Coronary Artery Fistula ◽

Left Main ◽

Symptomatic Disease ◽

Coronary Artery Fistulas ◽

The Right

The frequency of coronary artery fistula among all coronary angiography patients is 0.1% to 0.2%; however, involvement of both the pulmonary artery and the right ventricle is a rare clinical entity. A 53-year-old man patient was admitted to our clinic with rarely occurring chest pain, palpitations, and dyspnea. A coronary angiogram showed a fistula between the left main coronary artery and both the pulmonary artery and the right ventricle. We performed a ligation of this fistula without cardiopulmonary bypass. Aorta and right ventricle sutures were made, and the proximal and distal portions of the fistula were obliterated with 5-0 Prolene sutures and previously prepared Teflon felt. The patient recovered and was discharged without any complications. The surgical indications for coronary artery fistulas are symptomatic disease, an aneurysmic coronary artery, signs of heart failure, and ischemia. The surgical options in such cases�depending on whether the fistula is complicated or not�are simple ligation or transarterial ligation under cardiopulmonary bypass.

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ANOMALOUS AORTIC ORIGIN OF THE LEFT MAIN CORONARY ARTERY ASSOCIATED WITH ARTERIAL COMPRESSION - CASE REPORT

10.22541/au.160927527.79031349/v1 ◽

2020 ◽

Author(s):

Davi Tenório ◽

Leonardo Miana ◽

Antonio Carlos de Almeida Barbosa Filho ◽

Monica Gonzales Coronel ◽

Gustavo Guerreiro ◽

...

Keyword(s):

Coronary Artery ◽

Pulmonary Artery ◽

Left Coronary Artery ◽

Left Main Coronary Artery ◽

Postoperative Recovery ◽

Shortness Of Breath ◽

Left Main ◽

External Compression ◽

The Right

Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. We present a case of an 11-year-old female who presented with episodes of shortness of breath, angina and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. Patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with autologous pericardium and creation of neo-ostium in aorta. Patient had satisfactory postoperative recovery, was discharged on the fifth day post op, and remains asymptomatic after six months follow-up. Herein we present surgical video and postoperative echo and CT scan.

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Incidentally Diagnosed Malignant Coronary Artery Anomaly: A Clinical Case

Medicina ◽

10.3390/medicina49100072 ◽

2013 ◽

Vol 49 (10) ◽

pp. 72

Author(s):

Domas Golubickas ◽

Justina Motiejūnaitė ◽

Antanas Jankauskas ◽

Rimvydas Šlapikas ◽

Algidas Basevičius

Keyword(s):

Coronary Artery ◽

Pulmonary Artery ◽

Left Main Coronary Artery ◽

Coronary Artery Anomalies ◽

Heavy Exercise ◽

Left Main ◽

Investigation Methods ◽

The Right ◽

Congenital Coronary Artery Anomalies ◽

Myocardial Hypoperfusion

The incidence of congenital coronary artery anomalies is estimated to range between 1% and 2% in the general population. The separate types of coronary artery anomalies are even rarer – the left main coronary artery arising from the right coronary sinus and passing between the thoracic aorta and the pulmonary artery is one of them. In this case, the segment of the artery that courses between the aorta and the pulmonary artery is prone to compression, especially during heavy exercise. Outcomes may be fatal due to myocardial hypoperfusion, which is associated with sudden cardiac death especially among children, young adults, and athletes. Nowadays, innate coronary artery anomalies may be incidentally diagnosed in older age using new investigation methods such as computed tomography angiography.

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A Rare Coronary Artery Anomaly: Left Main Coronary Artery Originating From the Right Sinus of Valsalva and Successful Percutaneous Coronary Intervention of Left Anterior Descending Artery

International Journal of the Cardiovascular Academy ◽

10.1016/j.ijcac.2016.11.016 ◽

2016 ◽

Vol 2 (4) ◽

pp. 185

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Left Main Coronary Artery ◽

Coronary Intervention ◽

Coronary Artery Anomaly ◽

Sinus Of Valsalva ◽

Left Main ◽

Left Anterior Descending Artery ◽

Percutaneous Coronary ◽

The Right

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Left Main Coronary Artery Compression by Right Ventricle-to-Pulmonary Artery Conduit Relieved by Anterior Translocation of the Right Pulmonary Artery

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135111403780 ◽

2011 ◽

Vol 2 (3) ◽

pp. 502-504

Author(s):

Sameh M. Said ◽

Harold M. Burkhart ◽

Sabrina D. Phillips ◽

Joseph A. Dearani

Keyword(s):

Coronary Artery ◽

Pulmonary Artery ◽

Right Ventricle ◽

Left Main Coronary Artery ◽

Left Main ◽

Right Pulmonary Artery ◽

The Right ◽

Artery Conduit

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An interarterial course of anomalous coronary artery and an alternative surgical option

Cardiology in the Young ◽

10.1017/s1047951111002113 ◽

2012 ◽

Vol 22 (5) ◽

pp. 536-538 ◽

Cited By ~ 3

Author(s):

Kachaporn Nimdet ◽

Jarupim Soongswang ◽

Somchai Sriyodchati

Keyword(s):

Coronary Artery ◽

Left Main Coronary Artery ◽

Rare Condition ◽

Sinus Of Valsalva ◽

Left Main ◽

Surgical Options ◽

The Right ◽

Anomalous Coronary ◽

Surgical Option

AbstractAn interarterial course of anomalous left main coronary artery originating from the right aortic coronary sinus of valsalva is a rare condition among anomalous aortic origin of the coronary artery. Various surgical options are available. We performed an alternative procedure, that is, mobilisation of the pulmonic root, pulmonary bifurcation, and plication of the pulmonic root adjacent to the left main coronary artery, in a 12-year-old boy. Favourable results were achieved after 43 months of follow-up.

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