Hooda Zamaan, Rifai Yasmine, LeBow Elissa, Bustamante John Paul, Cerda Luis, Zaku Bledi
Department of Cardiothoracic Surgery, St. Joseph's University Medical Center, Paterson, NJ 07503, United States.
Department of Surgery, Hackensack Meridian School of Medicine, Nutley, NJ 07110, United States.
J Surg Case Rep. 2024 Jul 13;2024(7):rjae348. doi: 10.1093/jscr/rjae348. eCollection 2024 Jul.
Anomalous aortic origin of the right coronary artery (RCA) is a rare anatomic anomaly that is present in ~1% of the general population, and is often discovered incidentally through imaging performed for another purpose. Despite being an uncommon phenomenon, aberrant right coronary arterial origins can have devastating manifestations in half of affected patients. These include myocardial infarction, arrhythmias, heart failure, syncope, and sudden cardiac death secondary to ischemia of the cardiac tissue. This report describes a case of a 48-year-old female patient that was initially found to have ST-elevation myocardial infarction. During cardiac catheterization, the patient was discovered to have a type A aortic dissection. Cardiothoracic surgery was consulted, and she was immediately transferred to the operating room for repair. During the procedure, an anomalous RCA was discovered with its origin in the dissected tissue, which was initially ligated and then bypassed using greater saphenous vein graft.
右冠状动脉（RCA）起源异常是一种罕见的解剖学异常，在普通人群中的发生率约为1%，常因其他目的进行的影像学检查而偶然发现。尽管这是一种不常见的现象，但异常的右冠状动脉起源在一半的受影响患者中可能会有灾难性表现。这些表现包括心肌梗死、心律失常、心力衰竭、晕厥以及继发于心脏组织缺血的心脏性猝死。本报告描述了一例48岁女性患者，最初被发现患有ST段抬高型心肌梗死。在心脏导管插入术中，发现该患者患有A型主动脉夹层。咨询心胸外科后，她立即被转移到手术室进行修复。在手术过程中，发现一条异常的右冠状动脉起源于夹层组织，最初对其进行了结扎，然后使用大隐静脉移植物进行了旁路移植。
