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International Society For Minimally Invasive Cardiothoracic Surgery

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Unroofing Technique For Anomalous Right Coronary Artery Is Safe And Effective: A Case Report
Tamer M. Abdalghafoor, Laith Tbishat, Ali Kindawi, Hatem Sarhan, Bassam Shoman.
Hamad Medical Corporation, Doha, Qatar.

Unroofing technique for anomalous right coronary artery is safe and effective: A case report
Abstract Background: Anomalous origin of coronary arteries (AOCA) is the second most common cause of sudden cardiac death (SCD) in young people.1 The arterial course determines clinical significance from a benign entity, ectopic origin from the opposite coronary sinus with malignant course subjects the vessel to various forms of compression during exercise along with a likely abnormal tight ostium. Although most cases are diagnosed incidentally during various cardiac imaging studies; they can present with ischemia-related symptoms.2 Surgery is the mainstay of treatment to avoid SCD and related morbidity.3,4 Case summary: Here we report a case of a young male patient who has been suffering from disabling anginal pain and was diagnosed to have an anomalous aortic origin of the right coronary artery (RCA) originating from the left sinus of Valsalva and underwent a successful surgical repair. Discussion: Congenital coronary artery anomalies (CAA) are a rare entity and generally incidentally diagnosed but can have serious implications. Sudden cardiac death in young healthy individuals is the main feared outcome.1 Only a minority of patients will present with symptoms of chest pain or syncope, like in our case. Computed tomography (CT) scan or magnetic resonance angiography (MRA) is the current recommended study for diagnosis and can in most cases visualize the anatomy and arterial course accurately along with the assessment of intramural segment. 2-5 Surgery is considered the treatment of choice. Unroofing technique is generally preferred and superior to bypass grafting in many cases. Keywords: Anomalous right coronary artery, Angiography, Unroofing, Case report





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