Occlusion of the right coronary artery ostium by an aortic cusp attachment.
Occlusion of the right coronary artery (RCA) ostium by an aortic cusp is a rare anomaly and can be a cause of sudden death. We report the case of a child with progressive stenosis of the right coronary ostium caused by a hypoplastic right coronary cusp that adhered to the aortic wall resulting in severe myocardial ischemia. The patient underwent a Ross-Konno operation with mitral valvuloplasty for congenital aortic valvular stenosis and mitral regurgitation caused by ischemia-induced posteromedial papillary muscle dysfunction. The myocardial ischemia was relieved by resection of the deformed pouch-like cusp to disclose the RCA ostium. Postoperative myocardial scintigraphy demonstrated no myocardial ischemia and multidetector computed tomography showed no coronary ostial stenosis.
Shikata
Fumiaki
F
Department of Cardiovascular Surgery, Ehime University, Shitsukawa, Toon City, Ehime 791-1125, Japan.
Nagashima
Mitsugi
M
Higaki
Takashi
T
Kawachi
Kanji
K
D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods; D054059:Coronary Occlusion / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004452:Echocardiography; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000151:congenital / Q000601:surgery; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D055414:Myocardial Perfusion Imaging; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome