Retroaortic Coronary Artery: Possible Contraindication for Device Closure of Atrial Septal Defect
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Anomalous origin of the coronary artery from the opposite aortic sinus is an infrequently encountered clinical problem. Incidence of this abnormality was approximately 1.69% in the angiographic study by Angelini et al. . This abnormal vessel can have a retroaortic course before it reaches the atrioventricular or interventrivular groove.
Atrial septal defect is one of the common forms of congenital heart disease, and percutaneous device closure is an alternative to surgery. The presence of adequate rims around the defect, except for the aortic rim, is an essential prerequisite for device closure because the device splays over the atrial roof onto either side of the aorta. However, an abnormal coronary artery arising from the opposite aortic sinus with retroaortic course will be in close relation to the aortic rim of the defect. When the left circumflex artery arises from the right coronary sinus, it usually has a retroaortic course. This anomaly was observed in 0.67% of patients in...
KeywordsAtrial Septal Defect Device Closure Anomalous Origin Aortic Sinus Abnormal Coronary Artery
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