A clinical report on the anomalous aortic origin of the right coronary artery

Anomalous aortic origin of the right coronary artery (AAORCA) is a rare congenital anomaly where the right coronary artery originates abnormally from the aorta, posing risks such as myocardial ischemia and sudden cardiac death, particularly in young athletes. Symptoms range from being asymptomatic to exertional signs such as dizziness or chest pain. Diagnosis is typically made using coronary computed tomography angiography, the gold standard for detailed assessment. Treatment depends on symptom severity, ranging from medical management to surgical options such as unroofing, reimplantation, or bypass grafting. This report presents a case of a 9-year-old patient diagnosed with AAORCA, exhibiting mild symptoms in the absence of exertional intolerance. This case emphasizes the importance of imaging, regular follow-ups, and early diagnosis. Personalized treatment and further research are crucial for improving outcomes and reducing the risk of sudden cardiac death in AAORCA patients.
- Toufayli HY, El Hachem GY, Salengro E. A very rare case of an anomalous right coronary artery originating from the proximal aortic arch. Cureus. 2024;16(12):e75080. doi: 10.7759/cureus.75080
- Xie Z, Zou J, Zhu H, Bu H. Case report: Anomalous origin of the right coronary artery from the left sinus of valsalva with aortic dissection: New myocardial ischemia mechanism. Front Cardiovasc Med. 2022;9:900803. doi: 10.3389/fcvm.2022.900803
- Rizzo S, De Gaspari M, Frescura C, Padalino M, Thiene G, Basso C. Sudden death and coronary artery anomalies. Front Cardiovasc Med. 2021;8:636589. doi: 10.3389/fcvm.2021.636589
- Padalino MA, Jegatheeswaran A, Blitzer D, Ricciardi G, Guariento A. Surgery for anomalous aortic origin of coronary arteries: Technical safeguards and pitfalls. Front Cardiovasc Med. 2021;8:626108. doi: 10.3389/fcvm.2021.626108
- Rahmouni K, Bernier PL. Current management of anomalous aortic origin of a coronary artery: A pan-Canadian survey. World J Pediatr Congenit Heart Surg. 2021;12(3):387-393. doi: 10.1177/2150135121999030
- Gaudino M, Di Franco A, Arbustini E, et al. Management of adults with anomalous aortic origin of the coronary arteries: State-of-the-art review. J Am Coll Cardiol. 2023;82(21):2034-2053. doi: 10.1016/j.jacc.2023.08.012
- Verheijen DBH, Egorova AD, Jongbloed MRM, et al. Anomalous aortic origin of the right coronary artery: Invasive haemodynamic assessment in adult patients with high-risk anatomic features. CJC Pediatr Congenit Heart Dis. 2023;2(3):124-133. doi: 10.1016/j.cjcpc.2023.03.001
- Bibevski S, Ruzmetov M, Turner II, Scholl FG. Anomalous aortic origin of right coronary artery: Outcomes of surgical and nonsurgical treatment. Ann Thorac Surg. 2022;114(6):2338-2345. doi: 10.1016/j.athoracsur.2021.11.008
- Gharibeh L, Rahmouni K, Hong SJ, Crean AM, Grau JB. Surgical techniques for the treatment of anomalous origin of right coronary artery from the left sinus: A comparative review. J Am Heart Assoc. 2021;10(22):e022377. doi: 10.1161/JAHA.121.022377
- Molossi S, Martínez-Bravo LE, Mery CM. Anomalous aortic origin of a coronary artery. Methodist Debakey Cardiovasc J. 2019;15(2):111-121. doi: 10.14797/mdcj-15-2-111
- Cheezum MK, Liberthson RR, Shah NR, et al. Anomalous aortic origin of a coronary artery from the inappropriate sinus of valsalva. J Am Coll Cardiol. 2017;69:1592-1608. doi: 10.1016/j.jacc.2017.01.031
- Lorenz EC, Mookadam F, Mookadam M, Moustafa S, Zehr KJ.A systematic overview of anomalous coronary anatomy and an examination of the association with sudden cardiac death. Rev Cardiovasc Med. 2006;7:205-213.
- McCaffrey FM, Braden DS, Strong WB. Sudden cardiac death in young athletes. A review. Am J Dis Child. 1991;145:177-183. doi: 10.1001/archpedi.1991.02160020069020
- Gersony WM. Management of anomalous coronary artery from the contralateral coronary sinus. J Am Coll Cardiol. 2007;50:2083-2084. doi: 10.1016/j.jacc.2007.08.023
- Doorey AJ, Pasquale MJ, Lally JF, Mintz GS, Marshall E, Ramos DA. Six-month success of intracoronary stenting for anomalous coronary arteries associated with myocardial ischemia. Am J Cardiol. 2000;86:580-582, A10. doi: 10.1016/s0002-9149(00)01023-7