Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Coronary Artery Bypass Grafting in Patients with Acute Myocardial Infarction with an Abnormal Origin of the Right Coronary Artery

우관상동맥 이상기시를 동반한 급성 심근경색 환자에서의 관상동맥우회술

  • Choi, Si-Young (Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University College of Medicine) ;
  • Kim, Yong-Hwan (Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University College of Medicine) ;
  • Suh, Jong-Hi (Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University College of Medicine)
  • 최시영 (가톨릭대학교 의과대학 의정부성모병원 흉부외과학교실) ;
  • 김용환 (가톨릭대학교 의과대학 의정부성모병원 흉부외과학교실) ;
  • 서종희 (가톨릭대학교 의과대학 의정부성모병원 흉부외과학교실)
  • Published : 2008.10.05
Download PDF
⟨ Previous Next ⟩

Abstract

An abnormal origin of the right coronary artery can be responsible for sudden death, myocardial ischemia, arrhythmia and syncope, and it may be associated with the accelerated development of atherosclerotic disease. The mechanisms of ischemia in the case of an abnormal origin of the right coronary artery are currently unclear and several surgical methods have been proposed to treat this malady. Multidetector Computed Tomography shows the course of the abnormal coronary artery, it helps to clarify the mechanism of the ischemia and it aids in choosing the best surgical approach. We report here on a case of acute myocardial infarction with an abnormal origin of the right coronary artery. Coronary artery bypass grafting was subsequently carried out to treat this patient.

우관상동맥 이상기시는 급사, 심근경색, 부정맥이나 실신을 일으킬 수 있으며, 관상동맥경화를 진행시키는 요인으로 여겨진다. 우관상동맥 이상기시에서의 심근 허혈의 기전은 확실하지 않으며, 여러 가지 수술적 치료방법이 보고되고 있다. 다절편 전산화흉부단층촬영은 비정상적인 관상동맥의 경로와 심근 허혈의 기전을 밝혀 적절한 수술적 치료를 결정하는데 도움이 된다. 저자들은 우관상동맥 이상기시와 함께 급성 심근 경색이 있었던 환자에 있어서 관상동맥우회술로 치료한 증례를 보고하는 바이다.

Keywords

References

  1. Jim MH, Siu CW, Ho HH, Miu R, Lee SW. Anomalous origin of the right coronary artery from the left coronary sinus is associated with early development of coronary artery disease. J Invasive Cardiol 2004;16:466-8
  2. Garcia-Rinaldi R, Sosa J, Olmeda S, Cruz H, Carballido J, Quintana C. Surgical treatment of right coronary arteries with anomalous origin and slit ostium. Ann Thorac Surg 2004;77:1525-9 https://doi.org/10.1016/j.athoracsur.2003.08.084
  3. Park CB, Jo MS, Kim YD, et al. Unroofing procedure in the treatment of a anomalous origin of right coronary artery from left sinus of Valsalva between aorta and pulmonary trunk. Korean J Thorac Cardiovasc Surg 2005;38:776-9
  4. Park JS, Park CH, Lee HL, et al. Extended unroofing procedure for creation of a new ostium for an anomalous right coronary artery originating from the left coronary sinus. Korean J Thorac Cardiovasc Surg 2008;41:102-5
  5. Basso C, Maron BJ, Corrado D, Thiene G. Clinical profile of congenital coronary artery abnormalities with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol 2000;35:1493-501 https://doi.org/10.1016/S0735-1097(00)00566-0
  6. Hariharan R, Kacere RD, Angelini P. Can stent-angioplasty be a valid alternative to surgery when revascularization is indicated for anomalous origination of a coronary artery from the opposite sinus? Tex Heart Inst J 2002;29:308-13
  7. Di Lello F, Mnuk JF, Flemma RJ, Mullen DC. Successful coronary reimplantation for anomalous origin of the right coronary artery form the left sinus of valsalva. J Thorac Cardiovasc Surg 1991;102:455-6
  8. Shah AS, Milano CA, Lucke JP. Anomalous origin of the right coronary artery from the left coronary sinus: case report and review of surgical treatments. Cardiovasc Surg 2000;8:284-6 https://doi.org/10.1016/S0967-2109(00)00025-9