Right Coronary Artery with an Intramural and Interarterial Course as a Unique Cause of Myocardial Ischemia: The Unroofing Method Might Still Be the Best Solution

A 39-year-old man was admitted because of cardiac arrest. Emergent coronary angiography revealed a preserved coronary blood flow; however, multiple-row detector computed tomography (MDCT) revealed that the proximal right coronary artery (RCA) was running inside the aortic wall, creating proximal ste...

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Detalles Bibliográficos
Autores principales: Aoki, Ryota, Kozai, Toshiyuki, Ono, Yoshiyasu, Tanaka, Fumiaki, Ueda, Yoko, Ikeda, Jiro, Matsuo, Atsutoshi, Hori, Hidetsugu, Hosokawa, Yukio, Okazaki, Teiji, Kosuga, Tomokazu, Yoshitake, Kiyonobu, Kosuga, Kenichi, Aoyagi, Shigeaki, Tayama, Keiichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037012/
https://www.ncbi.nlm.nih.gov/pubmed/35908964
http://dx.doi.org/10.2169/internalmedicine.0127-22
Descripción
Sumario:A 39-year-old man was admitted because of cardiac arrest. Emergent coronary angiography revealed a preserved coronary blood flow; however, multiple-row detector computed tomography (MDCT) revealed that the proximal right coronary artery (RCA) was running inside the aortic wall, creating proximal stenosis without atherosclerotic changes. Surgical intervention with unroofing was performed; however, postoperative stenosis of the proximal RCA required additional coronary artery bypass grafting (CABG). Intraoperative findings during CABG did not reveal hematoma or coronary dissection. However, MDCT one year after CABG depicted improvement of the RCA and graft stenoses, suggesting that the post-unroof stenosis may have been caused by an inflammatory reaction after surgical intervention.

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