Right coronary artery ligation successfully eliminated the coronary steal phenomenon and improved NYHA cardiac function from class II to I in a patient with ARCAPA and coronary atherosclerosis.
Case Report (n=1)
No
Does right coronary artery ligation and secondary prevention drug therapy improve symptoms and cardiac function in a patient with ARCAPA and multi-vessel coronary atherosclerosis?
Right coronary artery ligation followed by medical therapy may be an effective individualized staged treatment strategy for adults with ARCAPA and coexisting coronary atherosclerosis.
Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary artery malformation, with an adult incidence of approximately 0.002%. Due to the “coronary steal” phenomenon, it can lead to myocardial ischemia and pose a potentially fatal risk. This paper reports a case of a 54-year-old female with ARCAPA complicated by multi-vessel coronary atherosclerosis. Coronary CTA was used to clarify the malformed anatomy and the steal phenomenon, and to evaluate the degree of coronary artery stenosis. A staged treatment strategy was adopted: the main trunk of the right coronary artery was ligated first to eliminate the “coronary artery steal,” and intensive secondary prevention drug therapy for coronary heart disease was administered after the operation. The patient's symptoms were relieved, and follow-up showed improvement in cardiac function. This case highlights the value of coronary CTA in the diagnosis of complex heart diseases and demonstrates the importance of an individualized staged treatment strategy when congenital and acquired heart diseases coexist.
Zhang et al. (Wed,) conducted a case report in Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) complicated by multi-vessel coronary atherosclerosis (n=1). Right coronary artery trunk ligation was evaluated on Correction of coronary steal phenomenon and symptom relief. Right coronary artery ligation successfully eliminated the coronary steal phenomenon and improved NYHA cardiac function from class II to I in a patient with ARCAPA and coronary atherosclerosis.