Title: An Adult Case of Isolated Anomalous Origin of the Right Coronary Artery from the Main Pulmonary Artery
Abstract: Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital anomaly. We report a case of isolated ARCAPA in an adult patient who underwent reimplantation of the right coronary artery (RCA) into the aorta under cardiopulmonary bypass. The patient was diagnosed with ARCAPA during an examination for a lung mass. Cardiac scintigraphy using 99mthallium and 123I-β-methyl-P-iodophenyl-pentadecanoic acid showed myocardial ischemia in the area of the RCA. Cardiac catheterization showed a pulmonary/systemic flow ratio (Qp/Qs) of 1.38. To prevent coronary steal and establish a 2-vessel coronary artery system originating from the aorta, reimplantation of the RCA to the ascending aorta and closure of the main pulmonary artery were performed. The postoperative course was uncomplicated and the patient was discharged on the eleventh day after surgery. Postoperative coronary computed tomography showed good patency of the RCA.