Abstract
The anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva coursing between the aorta and the pulmonary artery or right ventricular outflow tract, is considered a potentially fatal abnormality which may require surgery. However, diagnosing the correct course with coronary arteriography may be difficult. Fast gradient echo magnetic resonance (MR) imaging can be helpful to identify and confirm the course of aberrant coronary arteries and their relationship to the surrounding tissue. In this study, diagnostic procedures and management are described of four patients in whom the RCA originated from the left sinus of Valsalva. Although reported as investigational by the Task Force document on MR imaging by the European Society of Cardiology we are of the opinion that MR coronary angiography may have an important future role in the assessment of anomalous coronary arteries.
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Yamanaka O, Hobbs RE. Coronary artery anomalies in 126, 595 patients undergoing coronary arteriography. Cath Cardiovasc Diagn 1990; 21: 28-40.
Serota H, Barth CW, Seuc CA, Vandormael M, Aguirre F, Kern M. Rapid identification of the course of anomalous coronary arteries in adults: the “dot” and “eye” method. Am J Cardiol 1990; 65: 891-8.
Brandt B, Martins JB, Marcus ML. Anomalous origin of the right coronary artery from the left sinus of Valsalva. N Eng J Med 1983; 309: 596-8.
McConnell MV, Ganz P, Selwyn AP, Li W, Edelman RR, Manning WJ. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation 1995; 92: 3158-62.
Post JC, van Rossum AC, Bronzwaer JGF, et al. Magnetic resonance angiography of anomalous coronary arteries. A new gold standard for delineating the proximal course? Circulation 1995; 92: 3163-71.
Vliegen HW, Doornbos J, de Roos A, Jukema JW, Bekedam MA, van der Wall EE. Value of fast gradient echo magnetic resonance angiography as an adjunct to coronary arteriography in detecting and confirming the course of clinically significant coronary artery anomalies. Am J Cardiol 1997; 79: 773-6.
Roberts WC, Siegel RJ, Zipes DP. Origin of the right coronary artery from the left sinus of Valsalva and its functional consequences: analysis of 10 necropsy patients. Am J Cardiol 1982; 49: 863-8.
Grollman JH, Mao SS, Weinstein SR. Arteriographic demonstration of both kinking at the origin and compression between the great vessels of an anomalous right coronary artery arising in common with a left coronary artery from above the left sinus of Valsalva. Cathet Cardiovasc. Diagn 1992; 25: 46-51.
Fournier JA, Gonzalez-Barrero A, Fernandez-Cortacero JAP, Sanchez A. Coronay angioplasty of anomalous right coronary artery originating from the left sinus of Valsalva. Int J Cardiol 1995; 49: 284-6.
Ishikawa T. Brandt P. Anomalous origin of the left main coronary artery from the right anterior aortic sinus: angiographic definition of anomalous course. Am J Cardiol 1985; 55: 770-6.
Sasson Z, Grande P, Lorette I, McEwan P. Proximal narrowing of anomalous right coronary artery from the left coronary sinus: Deliniation by omniplane transesophageal echocardiogram. Can J Cardiol 1996; 12: 529-31.
Kaku B, Shimizu M, Yoshio H et al. Clinical features of prognosis of Japanese patients with anomalous origin of the coronary artery. Jpn Circ J 1996; 60: 731-41.
Ghosh PK, Agarwal SK, Kumar R, Chandra N, Puri VK. Anomalous origin of right coronary artery from left aortic sinus. J Cardiovasc Surg 1994; 35: 65-70.
Chakraborty B, Chan CNS, Tan A. Percutaneous transluminal coronary angioplasty of an anomalous right coronary artery arising from a separate ostium in the left sinus of Valsalva. Angiology 1995; 46: 629-32.
Mooss AN, Heintz MH, Percutaneous transluminal angioplasty of right coronary artery. Cathet Cardiovasc Diagn 1989; 16: 16-8.
Topaz O, DiSciascio G, Goudreau E, Cowley MJ, Nath A, Kohli RS, Vetrovec GW. Coronary angioplasty of anomalous coronary arteries: notes on technical aspects. Cathet Cardiovasc Diagn 1990, 21: 106-111.
Musial B, schob A, de Marchena E, Kessler KM. Percutaneous transluminal coronary angioplasty of anomalous right coronary artery. Cathet Cardiovasc Diagn 1991; 22: 39-41.
Sechtem UP, Neubauer S, Revel D et al. The clinical role of magnetic resonance in cardiovascular disease. Report of a Task Force of the European Society of Cardiology, in collaboration with the Association of European Pediatric Cardiologists. Eur Heart J 1998; 19: 19-39.
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Bekedam, M.A., Vliegen, H.W., Doornbos, J. et al. Diagnosis and management of anomalous origin of the right coronary artery from the left coronary sinus. Int J Cardiovasc Imaging 15, 253–258 (1999). https://doi.org/10.1023/A:1006161821388
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DOI: https://doi.org/10.1023/A:1006161821388