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Anomalous aortic origin of the left main coronary artery associated with arterial compression—Case report
Author(s) -
Tenório Davi F.,
Miana Leonardo A.,
Almeida Barbosa Filho Antonio C.,
Guerreiro Gustavo P.,
Coronel Monica R. G.,
Manuel Valdano,
Jatene Marcelo B.,
Jatene Fábio B.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15578
Subject(s) - medicine , cardiology , aorta , arteriotomy , asymptomatic , right coronary artery , artery , angina , radiology , left coronary artery , aortic dissection , myocardial infarction , coronary angiography
Background Anomalous aortic origin of coronary artery is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. Case presentation We present a case of an 11‐year‐old female who presented with episodes of shortness of breath, angina, and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. The patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with the autologous pericardium, and creation of neo‐ostium in aorta. The patient had a satisfactory postoperative recovery, was discharged on the fifth‐day post‐op, and remains asymptomatic after 14 months of follow‐up. Herein we present surgical video and postoperative echo and computed tomography scan.