Consideration of the Necessity of Prophylactic Bypass Grafting for Anomalous Origin of the Right Coronary Artery—Based on a Case with Concomitant Left Main Trunk Disease Resuscitated from Cardiopulmonary Arrest
Anomalous origin of the right
coronary artery is a rare congenital anomaly, but is associated with sudden
death. Originating from the opposite sinus of Valsalva, an interarterial？course
and an intramural course are especially considered as the risk factor for fatal
cardiac events. Surgical indication remains controversial because many patients
are asymptomatic. A 52-year-old man with anomalous origin of the right coronary
artery with an interarterial？course concomitant with the left main trunk
disease was resuscitated from cardiopulmonary arrest. It was likely to be attributed
to the left main trunk disease, but anatomical structure of the right coronary
artery suggests its possible involvement. Prophylactic bypass grafting for the right
coronary artery was performed using saphenous vein graft without ligating
native vessel to prevent future cardiac events, as well as revascularization of
the left main trunk disease. All grafts were patent in one-year follow-up
coronary angiography. Any cardiac event has not occurred.
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