Author(s): Inafuku H, Kuniyoshi Y, Yamashiro S and Maeda T
An anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary artery malposition. We describe its surgical re-implantation in a 49-year-old man with marked dilatation of both coronary arteries. We decided to perform surgery based on intraoperative esophageal echocardiographic findings, 15 min after clamping the right coronary artery at its origin. Re-implantation from the main pulmonary artery to the ascending aorta was performed successfully. The dilated left coronary artery had diminished in size. Pathological findings of the excised proximal arterial wall of the ARCAPA showed much amount of elastic fibers in the arterial wall as an elastic artery thought to have originated from the pulmonary trunk.
