Improvement of the Ischemic Area after Surgical Treatment for Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery

Minoru Matsuhama＊	Satoshi Arimura＊	Kenichi Sasaki＊＊
Takashi Kunihara＊＊＊

（Division of Cardiovascular Surgery, The Cardiovascular Institute＊, Tokyo, Japan, Division of Cardiovascular Surgery, Saitama Sekishinkai Hospital＊＊, Saitama, Japan, and Division of Cardiac Surgery, The Jikei University School of Medicine＊＊＊, Tokyo, Japan）

Anomalous origin of the right coronary artery from the pulmonary artery（ARCAPA）is a rare congenital coronary anomaly. Although asymptomatic in most cases, with the anomaly only being detected incidentally, surgical correction should be considered before onset of severe myocardial ischemia in such cases. Here, we present a 70-year-old man who was referred to our department due to chest pain on effort and was given a diagnosis of ARCAPA concomitant with mild aortic stenosis. As the symptoms and the degree of aortic stenosis deteriorated during follow-up, the patient underwent direct re-implantation of the right coronary artery into the ascending aorta and aortic valve replacement. The patient’s postoperative course was uneventful, and the symptoms disappeared. Postoperative myocardial perfusion scintigraphy revealed improvement of the myocardial ischemic area.

 

Jpn. J. Cardiovasc. Surg. 48:111-114（2019）

Keywords：anomalous origin of the right coronary artery from the pulmonary artery;myocardial perfusion scintigraphy;myocardial ischemia;re-implantation;aortic stenosis