Anomalous origin of the left main coronary artery from the right coronary sinus is rarely diagnosed in elderly patients. We report such an anomaly in a 75-year-old lady presenting with chest pain and syncope. Preoperative screening revealed that her aortic valve was moderately stenotic. The patient underwent a successful unroofing procedure combined with aortic valve replacement. The outcome was uncomplicated and the patient remained asymptomatic at one year postoperatively.
MustafaIGulaGRadley-SmithRDurrerSYacoubM. Anomalous origin of the left coronary artery from the anterior aortic sinus: a potential cause of sudden death. Anatomic characterization and surgical treatment. J Thorac Cardiovasc Surg1981; 82: 297–300.
2.
HoffmanJIKaplanSLiberthsonRR. Prevalence of congenital heart disease. Am Heart J2004; 147: 425–439.
CheitlinMDDe CastroCMMcAllisterHA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva, a not so minor congenital anomaly. Circulation1974; 50: 780–787.
5.
Rajasekhar D, Ghosh P, Chandra A, Raju N. Anomalous origin and course of left anterior descending coronary artery. Asian Cardiovasc Thorac Ann 1999;7:244–246. Available at:http://aan.sagepub.com/content/7/3/244.full. Accessed April 07, 2014.
6.
BenedettiMPrataliSSciotiGPetronioASBalbariniA. Solitary coronary ostium and aberrant coursing left coronary arteries: unfavorable anatomic anomaly in a case of aortic valve replacement [Letter]. J Thorac Cardiovasc Surg1995; 109: 1259–1262.
7.
GulatiRReddyVMCulbertsonC. Surgical management of coronary artery arising from the wrong coronary sinus, using standard and novel approaches. J Thorac Cardiovasc Surg2007; 134: 1171–1178.
