Pediatric Cardiology and Cardiac Surgery
Vol.26 No.5 2010 (428-433)

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Takashi Ono,1) Shigehiro Morishima,1)Makoto Nakazawa,2) and Yoshimichi Kudo3)

1)Department of Pediatric Cardiovascular Surgery, 2)Pediatric and Lifelong Congenital Cardiology Institute, 3)Department of Pediatrics, Southern Tohoku General Hospital, Koriyama, Japan


We performed simultaneous surgery for a ventricular septal defect and anomalous origin of a coronary artery in a 23-year-old woman. She had been diagnosed with a small infundibular muscular ventricular septal defect using echocardiography. Because recent echo findings revealed prolapse of the right coronary cusp and mild aortic valve regurgitation, we performed cardiac catheterization. Aortography showed an anomalous course of the right coronary artery besides obvious deformity of the right coronary cusp. Multi-detector computed tomography (MDCT) confirmed the anomalous origin of the right coronary artery from the left sinus of Valsalva with a suspected intramural course. Although she did not have any symptoms or findings of myocardial ischemia, simultaneous surgery was performed after informed consent of the possibility of sudden cardiac death if the coronary anomaly was left unrepaired. The right coronary artery arose from the same ostium of the left coronary artery as the left sinus of Valsalva and ran intramurally between the ascending aorta and main pulmonary artery. An unroofing of this right coronary artery and patch closure of the subarterial infundibular ventricular septal defect was performed. A postoperative MDCT study showed neither stenosis nor kinking at the repair site of the right coronary artery.