Right Coronary Artery Arising from the Left Aortic Sinus in a Heart with Left Coronary Dominance: A Post-Mortem Description

Abstract

The authors report the post-mortem description of the coronary arterial circulation of an 81-year-old man. The heart showed a concordant atrioventricular and ventricle- arterial disposition. The coronary artery distribution presented left dominance. No myocardial scars were observed. The ostium of the right coronary artery (RCA) was located in the left aortic sinus just in front of the opening of the left coronary artery. The ostium was slit-like and its maximun diameter was 5 mm. The RCA began between the aorta and the pulmonary trunk and ended as a small right marginal artery. The absence of heart disease and the man's survival until an advanced age were probably due to the fact that the RCA supplied only a small portion of the right ventricle, given the left coronary dominance.

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References

Angelini P. : Normal and anomalous coronary arteries : Definitions and classification Am Heart J 177: 418-434, 1989.

Neufeld HN , Schneeweiss A. : Coronary Artery Disease in Infants and Children Philadelphia : Lea & Febiger, 1983.

Alexander RW , Griffith GC : Anomalies of the coronary arteries and their clinical significance Circulation 14:800-805, 1956.

Chaitman BR , Lesperance J. , Saltiel J., et al : Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries Circulation 53:122-131, 1976.

Engel HJ , Torres C. , Page HL : Major variations in anatomical origin of the coronary arteries: Angiographic observations in 4250 patients without associated congenital heart disease Cathet Cardiovasc Diagn 1:157-169, 1975.

Schlesinger MJ : Relation of anatomic pattern to pathologic conditions of the coronary arteries Arch Pathol 30:403-415, 1940.

Benge W. , Martins JB , Funck DC : Morbidity associated with anomalous origin of the right coronary artery from the left sinus of Valsalva Am Heart J 99:96-100, 1980.

Roberts WC , Siegel RJ , Zipes DP : Origin of the right coronary artery from the left sinus of Valsalva and its functional consequences: Analysis of 10 necropsy patients Am J Cardiol 49:863-868, 1982.

Kragel AH , Roberts WC : Anomalous origin of either the right or left main coronary artery from the aorta with subsequent coursing between aorta and pulmonary trunk: Analysis of 32 necropsy cases Am J Cardiol 62:771-777, 1988.

10.

Cheitlin MD , De Castro C. , 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 50:780-787, 1974.

11.

Virmani R. , Chin Pkc , Goldstein RE, et al : Acute take-offs of the coronary arteries along the aortic wall and congenital coronary ostial valve-like ridges: Association with sudden death J Am Coll Cardiol 3:766-771, 1986.

12.

Benson PA , Lack AR : Anomalous aortic origin of left coronary artery Arch Pathol 86:214-216, 1968.

13.

Bloomfield P. , Erhlich C. , Folland ED, et al : Anomalous right coronary artery: A surgically correctable cause of angina pectoris Am J Cardiol 51:1235-1237, 1983.