Congenital Anomalies of the Coronary Arteries

2009 ◽  
Vol 5 (1) ◽  
pp. 12
Author(s):  
Peiman Jamshidi ◽  
Paul Erne ◽  
◽  

Multiple variations of congenital anomalies of the coronary arteries exist that may occur in isolation or in association with other congenital anomalies. They can cause myocardial ischaemia. A rare but potentially lethal condition is the anomalous origin of the left coronary artery from the pulmonary artery. The most common haemodynamically significant coronary abnormalities are coronary artery fistulae. A left-toright shunt exists in more than 90% of cases. The origin of the left coronary artery from the proximal right coronary artery (RCA) or the right aortic sinus with subsequent passage between the aorta and the right ventricular outflow tract has been associated with sudden death during or shortly after exercise in young persons. High anterior origin of the RCA is commonly encountered but is of no haemodynamic significance. It is difficult to engage the ostium of the RCA selectively using conventional catheter manipulation. In this article we will discuss various types of congenital coronary anomaly, providing examples.

2021 ◽  
pp. 20-22
Author(s):  
Sony Jhansi Priya ◽  
Sangeetha A ◽  
M. Sai Krishna

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.


Author(s):  
Waleed Albadi ◽  
Bernard Kreitmann ◽  
François Roubertie

Abstract The anomalous origin of the left coronary artery from the pulmonary artery in the position of a non-facing coronary sinus is extremely rare. The anatomical position of the ectopic ostia will determine which is the appropriate operative approach to create a dual-coronary supply. This report describes a technique of modified extra-anatomical rerouting using autologous pericardium patch and pulmonary artery flap to create a neo-composite coronary trunk passing anterior to the right ventricular outflow tract.


2005 ◽  
Vol 15 (2) ◽  
pp. 213-215 ◽  
Author(s):  
Masayuki Morikawa ◽  
Ko Bando ◽  
Shinji Sato

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.


2010 ◽  
Vol 20 (S3) ◽  
pp. 20-25 ◽  
Author(s):  
Anthony Hlavacek ◽  
Marios Loukas ◽  
Diane Spicer ◽  
Robert H. Anderson

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.


2021 ◽  
Vol 27 (4) ◽  
pp. 41-46
Author(s):  
U.Ye. Pidvalna ◽  
D.M. Beshley ◽  
M.Z. Mirchuk ◽  
L.R. Mateshuk-Vatseba

Morphometric analysis of the structures of the aortic bulb and coronary arteries is necessary for the planning of cardiac surgery and endovascular interventions. The aim of the study was to determine the height of the coronary arteries branching in healthy women of Lviv city and Lviv region and to determine the relationship between the height of the location of the orifice of the coronary artery with anthropometric indicators. Fifteen computed tomography images with contrast of female thorax without heart and ascending aortic lesions (normal) were selected for the study. The height of the upper and lower edges of the coronary arteries was measured; height of Valsalva sinuses. The comparison of the mean values was performed according to the Student’s t-test. The correlation between the observed variables (age, height, body weight, body mass index, body surface area, height of the sinuses of Valsalva) was calculated using the Pearson linear correlation method (r). According to the study, the population group consisted of persons of the second period of adulthood (46.67 %) and the elderly (53.33 %). According to the body mass index, 80 % were overweight or obese I-II degree. The mean height of the coronary artery orifice in women without structural changes of the heart and ascending aorta was: 11.19±1.96 mm for the left and 11.68±1.80 mm for the right. The height of the orifice of the right and left coronary arteries were almost the same, without statistical significance (p=0.26). Analysis of the correlation between the values of the height of the orifice of the coronary artery did not show a probable dependence on height, weight, age, body mass index and body surface area. There is a direct relationship between the parameters of the height of the lower edge of the right coronary artery and the height of the upper edge of the right coronary artery (r=+0.75, p=0.001) and between the value of the lower edge of the left coronary artery and the upper edge of the left coronary artery (r=+0.63, p=0.01). Thus, the analysis of the correlation between the values of the height of the orifice of the coronary artery in women in norm and anthropometric indicators did not show a significant relationship. There was no statistical significance between the indicators of the height of the orifice of the right and left coronary arteries in women.


2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmad Slim ◽  
John Thurlow ◽  
Jennifer Blevins ◽  
Shaun Martinho ◽  
Brian Markelz

This is the case of an 18 year old active duty soldier with symptoms of exertional chest pressure and syncope who was found to have anomalous origin of the left main coronary artery (LMCA) from the right coronary cusp (RCC) traveling partially between the great vessels before taking a septal approach between the left ventricular outflow tract (LVOT) and the right ventricular outflow tract (RVOT). Anomalous origin of coronary arteries is a rare condition that carries an increased risk of angina, myocardial ischemia, and sudden cardiac death (SCD). Surgical treatment of such anomalies with both high and lower risk features can be challenging, and traditional benefit from surgical correction may not be achieved due to complex anatomy. As evident by our patient, this rare condition even though benign from sudden death standpoint could be debilitating despite best efforts and available resources.


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