Nishijima Shuhei, Nakamura Yoshitugu, Ito Yujiro, Kuroda Miho, Masuda Takahiko, Kobayashi Kazuo, Handa Keita, Ohigashi Hirokazu, Sugiyama Koji, Kimura Yayoi
Department of Cardiovascular Surgery, Chibanishi General Hospital, Matsudo, Chiba, Japan.
Department of Cardiology, Kashiwa Municipal Hospital, Kashiwa, Chiba, Japan.
J Cardiol Cases. 2020 Jun 6;22(2):68-71. doi: 10.1016/j.jccase.2020.05.005. eCollection 2020 Aug.
Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare occurrence that requires surgical repair, typically via cardiopulmonary bypass (CPB). In this study, we present the case of a patient with ARCAPA with a high risk of cerebral infarction and left main trunk stenosis. However, because of the high risk of cerebral infarction, CPB was no longer an option during surgical intervention. Instead, we performed off-pump reimplantation of the ARCAPA to the ascending aorta and coronary artery bypass grafting of the left coronary artery. The patient had an uneventful postoperative course. Based on the successful outcomes of this case, we suggest off-pump reimplantation of the ARCAPA to the ascending aorta as a useful alternative for patients who are not eligible to undergo CPB during surgical repair. < Although surgical repair of the anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) usually requires cardiopulmonary bypass (CPB), we present a successful off-pump reimplantation for those who are not eligible to undergo CPB. We performed off-pump reimplantation of the ARCAPA to the ascending aorta and coronary artery bypass grafting of the left coronary artery. Therefore, we found off-pump reimplantation of the ARCAPA to the ascending aorta to be a useful alternative to CPB in high-risk patients.>.
右冠状动脉起源于肺动脉（ARCAPA）是一种罕见的情况，需要进行手术修复，通常通过体外循环（CPB）进行。在本研究中，我们报告了一例患有ARCAPA且有高脑梗死风险和左主干狭窄的患者。然而，由于脑梗死风险高，在手术干预期间体外循环不再是一种选择。相反，我们对该患者进行了非体外循环下将ARCAPA重新植入升主动脉以及左冠状动脉旁路移植术。患者术后恢复顺利。基于该病例的成功结果，我们建议对于在手术修复期间不符合进行体外循环条件的患者，非体外循环下将ARCAPA重新植入升主动脉是一种有用的替代方法。<虽然右冠状动脉起源于肺动脉（ARCAPA）的手术修复通常需要体外循环（CPB），但我们为那些不符合进行体外循环条件的患者提供了一次成功的非体外循环下重新植入手术。我们对该患者进行了非体外循环下将ARCAPA重新植入升主动脉以及左冠状动脉旁路移植术。因此，我们发现对于高危患者，非体外循环下将ARCAPA重新植入升主动脉是体外循环的一种有用替代方法。>
