An incidental encounter of a rare high take-off right coronary artery: A case report

RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoper...

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Autores principales: Deng, Xicheng, Huang, Peng, Chen, Wenjuan, Yang, Xiaohui, Liu, Qianjun, Xiao, Yunbin, He, Cheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690786/
https://www.ncbi.nlm.nih.gov/pubmed/29137093
http://dx.doi.org/10.1097/MD.0000000000008614
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author Deng, Xicheng
Huang, Peng
Chen, Wenjuan
Yang, Xiaohui
Liu, Qianjun
Xiao, Yunbin
He, Cheng
author_facet Deng, Xicheng
Huang, Peng
Chen, Wenjuan
Yang, Xiaohui
Liu, Qianjun
Xiao, Yunbin
He, Cheng
author_sort Deng, Xicheng
collection PubMed
description RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography. He was referred to our institution for elective surgery. DIAGNOSES: The preoperative echocardiogram confirmed the presence of an atrial septal defect, and during the surgical procedure, a high take-off right coronary artery was found. INTERVENTIONS: The atrial septal defect was closed surgically, and care was taken to avoid clamping the anomalous right coronary artery when placing the aortic cross-clamp. OUTCOMES: Postoperative echocardiogram verified the presence of the high take-off right coronary artery and a satisfactory repair of the atrial septal defect. The postoperative course was uneventful, and the patient was discharged on postoperative day 5. LESSONS: This case suggests that it is critical to perform echocardiography to assess the anatomy of the coronary arteries, especially in pediatric cardiac patients. In addition, multi-detector computed tomography may be considered if appropriate. Care should be taken to assess the coronary anatomy for anomalies during interventional therapy or surgery, especially in congenital cases.
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spelling pubmed-56907862017-11-28 An incidental encounter of a rare high take-off right coronary artery: A case report Deng, Xicheng Huang, Peng Chen, Wenjuan Yang, Xiaohui Liu, Qianjun Xiao, Yunbin He, Cheng Medicine (Baltimore) 3400 RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography. He was referred to our institution for elective surgery. DIAGNOSES: The preoperative echocardiogram confirmed the presence of an atrial septal defect, and during the surgical procedure, a high take-off right coronary artery was found. INTERVENTIONS: The atrial septal defect was closed surgically, and care was taken to avoid clamping the anomalous right coronary artery when placing the aortic cross-clamp. OUTCOMES: Postoperative echocardiogram verified the presence of the high take-off right coronary artery and a satisfactory repair of the atrial septal defect. The postoperative course was uneventful, and the patient was discharged on postoperative day 5. LESSONS: This case suggests that it is critical to perform echocardiography to assess the anatomy of the coronary arteries, especially in pediatric cardiac patients. In addition, multi-detector computed tomography may be considered if appropriate. Care should be taken to assess the coronary anatomy for anomalies during interventional therapy or surgery, especially in congenital cases. Wolters Kluwer Health 2017-11-10 /pmc/articles/PMC5690786/ /pubmed/29137093 http://dx.doi.org/10.1097/MD.0000000000008614 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3400
Deng, Xicheng
Huang, Peng
Chen, Wenjuan
Yang, Xiaohui
Liu, Qianjun
Xiao, Yunbin
He, Cheng
An incidental encounter of a rare high take-off right coronary artery: A case report
title An incidental encounter of a rare high take-off right coronary artery: A case report
title_full An incidental encounter of a rare high take-off right coronary artery: A case report
title_fullStr An incidental encounter of a rare high take-off right coronary artery: A case report
title_full_unstemmed An incidental encounter of a rare high take-off right coronary artery: A case report
title_short An incidental encounter of a rare high take-off right coronary artery: A case report
title_sort incidental encounter of a rare high take-off right coronary artery: a case report
topic 3400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690786/
https://www.ncbi.nlm.nih.gov/pubmed/29137093
http://dx.doi.org/10.1097/MD.0000000000008614
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