초록접수 현황
| 14F-209 | 포스터 발표 |
Asymptomatic Anomalous Right Coronary Artery from Pulmonary Artery in Early Infant
정유영, 한성준, 이연주, 강민웅, 강신광, 나명훈, 임승평, 유재현
Department of Thoracic and Cardiovascular Surgery, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
Background : Anomalous right coronary artery from pulmonary artery is a rare congenital coronary anomaly. The prevalence is about 0.002%. But it is a fatal anomaly and surgical repair is much needed even though it does not have any symptoms. Whereas patients with anomalous pulmonary origin of the left coronary artery usually present with signs of left ventricular ischemia and congestive heart failure in infancy, those with anomalous origin of the RCA may remain asymptomatic until adulthood. Even in asymptomatic patients, surgical correction is needed.
Methods : 2-month-old girl who suspected as Kawasaki disease was referred for echocardiography for evaluation of coronary artery lesion. On transthoracic echocardiography, the color-flow Doppler revealed anomalous flow to pulmonary artery with a large network of vessels anterior to the right ventricle. That was a right coronary artery originating from the main pulmonary artery, with ischemic change of posterior wall of left ventricle. Left ventricle function was preserved. A coronary angiogram demonstrated prominent the left main coronary artery, left anterior descending artery, and circumflex artery. After a slight delay, the posterior descending and right coronary artery were opacified in a retrograde fashion through collaterals of the left coronary system. The right coronary artery drained into the main pulmonary artery.
Results : The patient underwent right coronary artery transfer to aorta. The endotracheal tube was extubated 2 days after the operation. Postoperative echocardiography reveals normal regional wall motion and function. She discharged at postoperative day 7 without any complication.
Conclusion : An early asymptomatic infant with the anomalous right coronary artery from pulmonary artery may present with ischemic change, thus the surgical repair could be done as soon as possible.
Methods : 2-month-old girl who suspected as Kawasaki disease was referred for echocardiography for evaluation of coronary artery lesion. On transthoracic echocardiography, the color-flow Doppler revealed anomalous flow to pulmonary artery with a large network of vessels anterior to the right ventricle. That was a right coronary artery originating from the main pulmonary artery, with ischemic change of posterior wall of left ventricle. Left ventricle function was preserved. A coronary angiogram demonstrated prominent the left main coronary artery, left anterior descending artery, and circumflex artery. After a slight delay, the posterior descending and right coronary artery were opacified in a retrograde fashion through collaterals of the left coronary system. The right coronary artery drained into the main pulmonary artery.
Results : The patient underwent right coronary artery transfer to aorta. The endotracheal tube was extubated 2 days after the operation. Postoperative echocardiography reveals normal regional wall motion and function. She discharged at postoperative day 7 without any complication.
Conclusion : An early asymptomatic infant with the anomalous right coronary artery from pulmonary artery may present with ischemic change, thus the surgical repair could be done as soon as possible.
책임저자: 유재현
Department of Thoracic and Cardiovascular Surgery, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
연락처 : 정유영, Tel: 042-280-7374 , E-mail : yooychong@gmail.com
