[Anomalous origin of the right coronary artery from the left sinus of Valsalva: essential role of computed tomography to clarify the coronary artery course and literature review on diagnostic and therapeutic management in 215 cases].
Coronary artery anomalies are among the most confusing topics in cardiology. Although the medical community is increasingly aware that coronary anomalies can be fatal, the reasons for a sudden fatal event and the frequency with which it occurs are generally unclear. In addition, coronary anomalies are usually compatible with normal prenatal myocardial development and postnatal growth and function, even permitting intense athletic activity. Nevertheless, coronary anomalies may lead to a pathological state, which usually originates suddenly, and the diagnostic and therapeutic management remains controversial, as outlined in our review of 215 cases in the literature. We report the case of a 53-year-old female who presented with effort/stress angina. She underwent coronary angiography, which demonstrated no significant parietal lesions but an anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva: the RCA showed an anomalous course between the aorta and the pulmonary artery with systolic compression and potential myocardial ischemia. The patient was then referred for surgical treatment and, according to the surgeons, she underwent isolated coronary artery bypass with the right internal mammary artery on the RCA and ligature of the native RCA to prevent competitive flow.
Ilaria
I
Passaseo
Luca
L
Cacciotti
Giovanni Salvatore
GS
Camastra
Carla
C
Favoccia
Lorenzo
L
Pauselli
Gerardo
G
Ansalone
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed