Anomalous right coronary artery originating from the left main coronary artery with a course between the great vessels: A surgical management of a case and a review

Abstract

Anomalies of the coronary arteries are rare congenital disorders that because of their anomalous course can produce symptoms in some cases, such as angina, syncope or even sudden death. Furthermore, their therapeutic management is not well established. The case is presented of a 64 year-old male with symptoms of chest pain and repeated syncope, in which a single coronary artery is discovered with a right coronary artery that originates from the left main coronary artery and runs between the great arteries. The compression exercised by these structures is responsible for the patient's clinical condition, thus a more appropriate therapy is decided, such as a surgical approach involving the translocation of the right coronary artery to the corresponding sinus of Valsalva. This prevents the compression produced by the great arteries, as well as the need for coronary bypass surgery.The patient is asymptomatic at seven months after surgery. The surgical management of symptomatic coronary anomalies can be a safe alternative, especially incases in which the coronary anatomy helps to avoid a bypass. (C) 2016 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U.