Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-13T01:56:57.699Z Has data issue: false hasContentIssue false

Myocardial infarction in infancy caused by compression of an anomalous left coronary artery arising from the right coronary artery

Published online by Cambridge University Press:  21 January 2005

Christopher Duke
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, London, UK
Eric Rosenthal
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, London, UK
John M. Simpson
Affiliation:
Department of Paediatric Cardiology, Guy's Hospital, London, UK

Abstract

A 5-week-old child presented with a cardiac arrest secondary to myocardial ischaemia. Echocardiography demonstrated a single coronary artery arising from the right sinus of Valsalva. The coronary artery branched into left and right arteries, with the left artery then coursing anomalously in the tissue plane between the aortic root and the subpulmonary infundibulum. Compression of the left coronary artery caused severe myocardial ischaemia that resolved following construction of a bypass graft using the left internal thoracic artery. Stenosis at the anastomosis between the graft and the coronary artery was successfully treated by coronary angioplasty 2 years later.

Type
Brief Report
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990; 21: 2840.Google Scholar
Shirani J, Roberts WC. Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies. J Am Coll Cardiol 1993; 21: 137143.Google Scholar
Roberts WC, Dicicco BS, Waller BF, et al. Origin of the left main from the right coronary artery or from the right aortic sinus with intramyocardial tunneling to the left side of the heart via the ventricular septum. The case against clinical significance of myocardial bridge or coronary tunnel. Am Heart J 1982; 104: 303305.Google Scholar
Frommelt PC, Berger S, Pelech AN, Bergstrom S, Williamson JG. Prospective identification of anomalous origin of left coronary artery from the right sinus of valsalva using transthoracic echocardiography: importance of color Doppler flow mapping. Pediatr Cardiol 2001; 22: 327332.Google Scholar
Kothari SS, Talwar KK, Venugopal P. Septal course of the left main coronary artery from right aortic sinus and ventricular tachycardia. Int J Cardiol 1998; 66: 207209.Google Scholar
Cheitlin MD, De Castro CM, McAllister HA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva, a not-so-minor congenital anomaly. Circulation 1974; 50: 780787.Google Scholar
Schwarz ER, Hager PK, Uebis R, Hanrath P, Klues HG. Myocardial ischaemia in a case of a solitary coronary ostium in the right aortic sinus with retroaortic course of the left coronary artery: documentation of the underlying pathophysiological mechanisms of ischaemia by intracoronary Doppler and pressure measurements. Heart 1998; 80: 307311.Google Scholar
Schwarz ER, Klues HG, vom Dahl J, Klein I, Krebs W, Hanrath P. Functional characteristics of myocardial bridging. A combined angiographic and intracoronary Doppler flow study. Eur Heart J 1997; 18: 434442.Google Scholar
Klues HG, Schwarz ER, vom Dahl J, et al. Disturbed intracoronary hemodynamics in myocardial bridging: early normalization by intracoronary stent placement. Circulation 1997; 96: 29052913.Google Scholar
Moodie DS, Gill C, Loop FD, Sheldon WC. Anomalous left main coronary artery originating from the right sinus of Valsalva: pathophysiology, angiographic definition, and surgical approaches. J Thorac Cardiovasc Surg 1980; 80: 198205.Google Scholar