A Case of Coronary Artery Reimplantation for Anomalous Aortic Origin of a Right Coronary Artery in the Absence of Proved Ischemia
- VernacularTitle:心筋虚血を証明し得なかった右冠動脈起始異常に対し冠動脈移植術を施行した1例
- Author:
Takahisa TAKAHASHI
1
;
Keisuke SHUNTOH
2
;
Koki IKEMOTO
2
;
Kazunari OKAWA
2
;
Akiyuki TAKAHASHI
2
Author Information
- Keywords: anomalous aortic origin of a coronary artery; coronary artery with an interarterial course; coronary artery with a high orifice; coronary reimplantation
- From:Japanese Journal of Cardiovascular Surgery 2025;54(2):45-48
- CountryJapan
- Language:ja
- Abstract: The patient is a 47-year-old male who was rushed to the hospital after experiencing fainting during exertion. Head magnetic resonance imaging (MRI) and electroencephalography showed no abnormalities. Elevated myocardial biomarkers indicated cardiogenic syncope. Coronary angiography (CAG) and coronary computed tomography (CT) revealed that the right coronary artery originated above the right-left coronary cusp commissure and coursed between the aorta and pulmonary artery. While no definitive ischemia was observed in various tests, elevated cardiac enzymes upon admission suggested transient ischemia of the right coronary artery as a likely cause of the syncope. Consequently, right coronary reimplantation surgery was performed after thorough discussion with the patient. His recovery has been favorable, with no recurrence of symptoms observed during follow-up. Anomalous origin of the right coronary artery has been reported in asymptomatic cases or cases where ischemia cannot be confirmed, leading to varying treatment approaches. This report describes a case where successful coronary artery reimplantation was performed following syncope which triggered the discovery of anomalous right coronary artery origin. It includes a literature review to further explore this case.
