Unique Association of Aortopulmonary Window With Anomalous Origin of Left Coronary Artery From Pulmonary Artery in an Infant: A Blessing in Disguise?

Aortopulmonary window (APW) seen in association with anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is extremely uncommon. When faced with this combination, ALCAPA usually goes undetected since most of the clinical and echocardiographic features of ALCAPA, including ventricular dysfunction are absent due to co-existent pulmonary hypertension. Herein we report a 5-month-old child with a large APW in whom a preoperative computed tomography angiogram facilitated the diagnosis of ALCAPA. The case is described for its rarity and the challenges faced during management. Also, it is extremely crucial that this coronary anomaly is identified and corrected during surgery, since failure to do so results in unforeseen postoperative ventricular dysfunction.

Rare Case of Dual Right Coronary Artery Intervention Presenting as Acute Coronary Syndrome

Dual right coronary artery (RCA) is a very rare coronary anomaly. This anomaly is often undetected and may be totally asymptomatic to presenting as acute coronary syndrome. Here , we present a young diabetic male who presented with acute onset severe chest pain of 30 minutes duration which was managed as acute coronary syndrome ( NSTE-ACS). His urgent coronary angiogram revealed single ostial origin of right coronary artery (RCA) with total occlusion from proximal segment followed by double right coronary arteries with their respective distal branches.

Single coronary artery originating from right sinus. Role of MDCT and a review of literature

SCA from the right sinus is the rarest coronary anomaly. We describe 2 cases: 1 with SCA type-1RI; 2 with SCA type-2RII-A. Appropriate and successful treatment (CABG in case-1; PTCA in case-2) was chosen relying on accurate morphological description provided by MDCT, in order to recognize all the possible mechanisms of myocardial ischemia.

Incidental Detection of a Rare Coronary Anomaly During Catheter Ablation for Premature Ventricular Complexes: All in One Coronary Ostium

Single coronary artery is a rare congenital anomaly associated with sudden cardiac death even though most of the cases are asymptomatic. Cardiac computerized tomography angiography plays an essential role in establishing the diagnosis of single coronary artery and designating the arterial course. Being aware of coronary anomaly is crucial in some cases scheduled for catheter ablation of premature ventricular complex neighboring to coronary arteries to prevent radiofrequency ablation related vascular injury.

Primary Percutaneous Coronary Intervention in a Case of Dual Right Coronary Artery Presenting As Acute Coronary Syndrome

Dual right coronary artery (RCA) is a rare coronary anomaly. This anomaly is often undetected and may be totally asymptomatic to presenting as acute coronary syndrome. Here, we present a 41 year old male diabetic and smoker presented with acute onset severe chest pain of 30 minutes duration which was managed as acute coronary syndrome .His urgent coronary angiogram revealed single ostial origin of right coronary artery ( RCA) with total occlusion from proximal segment followed by double right coronary arteries with their respective distal branches.

Surgical treatment for anomalous origin of the right coronary artery from the pulmonary artery: a case report with five-year follow-up

Background Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital heart disease affecting about 0.002% of the population. Knowledge of ARCAPA is almost collected from case reports. The aim of this study was to provide a rare case to better understand this rare congenital coronary anomaly. Case presentation We report a rare case of an 18-year-old male who was initially referred because of heart murmur. Dilated and tortuous coronary arteries were detected by echocardiography and congenital coronary anomaly was suggested. Further coronary CT angiography confirmed the diagnosis of ARCAPA. Although dual coronary system provides favorable long-term outcome, bypass surgery was considered technically difficult due to the huge mismatch of caliber between the right coronary artery and graft vessels. Eventually, simple right coronary artery ligation was performed. The patient was followed up for about 5 years without evidence of atherosclerosis or myocardial ischemia. Conclusions ARCAPA presents as a rare congenital heart disease with variable clinical manifestations. Surgical treatment is highly recommended to re-establish dual coronary system and prevent further complications. To our best knowledge, only about 200 cases of ARCAPA has been reported.