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

作者：Deng, Xicheng^*; Huang, Peng; Chen, Wenjuan; Yang, Xiaohui; Liu, Qianjun; Xiao, Yunbin; He, Cheng

来源：Medicine, 2017, 96(45): e8614.

DOI：10.1097/MD.0000000000008614

• anomalous origin
• cardiac surgery
• high take-off
• right coronary artery

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.

• 出版日期2017-11
• 单位湖南省儿童医院