Gutti Ramasubrahmanyam, Pilla Aparna, Vasireddy Sailaja
Department of Cardiothoracic Surgery, CARE Hospitals, Road No. 1, Banjara Hills, Hyderabad, 530034 India.
Indian J Thorac Cardiovasc Surg. 2025 May;41(5):601-604. doi: 10.1007/s12055-024-01863-x. Epub 2024 Nov 25.
This case is an illustration of the complex interplay between congenital coronary anomalies like anomalous right coronary artery from pulmonary artery and acquired cardiovascular conditions like coronary artery disease (CAD) in adults. Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly which is typically diagnosed in childhood or young adulthood. There is limited data on the incidence of ARCAPA in older adults, particularly in association with CAD. Development of symptoms due to onset of significant stenosis in the left coronary artery system (left anterior descending artery and left circumflex artery), led to the discovery of ARCAPA in our case. Surgical correction is considered the treatment of choice in anomalous origin of coronary artery from pulmonary artery, regardless of the age of presentation and symptom status. While several surgical techniques for managing ARCAPA have been described, the goal of surgical intervention should be to restore the dual coronary system in order to optimize outcomes.
该病例说明了诸如起源于肺动脉的异常右冠状动脉等先天性冠状动脉异常与成人后天性心血管疾病如冠状动脉疾病（CAD）之间复杂的相互作用。起源于肺动脉的右冠状动脉异常（ARCAPA）是一种罕见的先天性冠状动脉异常，通常在儿童期或青年期被诊断出来。关于老年人中ARCAPA的发病率，尤其是与CAD相关的发病率，数据有限。由于左冠状动脉系统（左前降支动脉和左旋支动脉）出现严重狭窄而引发症状，从而在我们的病例中发现了ARCAPA。无论发病年龄和症状状态如何，手术矫正被认为是治疗起源于肺动脉的冠状动脉异常的首选方法。虽然已经描述了几种治疗ARCAPA的手术技术，但手术干预的目标应该是恢复双冠状动脉系统，以优化治疗效果。
