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J Thorac Cardiovasc Surg 2007;133:258-259
© 2007 The American Association for Thoracic Surgery

Brief Communication

Surgical treatment of a rare association: Aberrant right coronary origination, coronary arteriovenous fistula, and aortic root aneurysm

Frédéric Vanden Eynden, MDa, Philippe Demers, MDb,*, Bertrand Marcheix, MDb, Denis Bouchard, MDb, Raymond Cartier, MDb, Michel Pellerin, MDb

a Cardiac Surgery, Erasme Hospital, Free University of Brussels, Brussels, Belgium
b Cardiac Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.

Received for publication September 1, 2006; accepted for publication September 13, 2006.

* Address for reprints: Philippe Demers, MD, Heart Surgery, Heart Institute of Montreal, 5000 rue Bélanger, Montreal, Quebec, Canada. (Email: chagnondemers@videotron.ca).

The first 20% of the full text of this article appears below.


Figure 1
Drs Bouchard, Demers, and Vanden Eynden(left to right)


Coronary artery anomalies and coronary artery fistulas are rare congenital entities that are not usually associated. These two abnormalities combined made it possible for a third unusual event, namely annuloaortic ectasia in a young patient without any feature of connective tissue disease, to induce right ventricular failure. A modified Bentall procedure with reimplantation of the left coronary artery on the anterior portion of the prosthesis solved the three problems and restored right ventricular function.

Clinical Summary

A 39-year-old man of Philippine origin was admitted to the emergency department for increasing dyspnea. He had no past medical history, except arterial hypertension treated with angiotensin-converting enzyme inhibitors. Two weeks before admission, he started complaining of shortness of breath for usual physical activities without any thoracic discomfort, cough, or fever. The physical examination was unremarkable except for hypertension and a diastolic heart murmur, which was increased with handgrip. Chest radiography was pertinent for mild pulmonary edema, and the patient was treated accordingly. A cardiac echocardiogram showed an enlarged aortic root, ascending aorta, and . . . [Full Text of this Article]






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Copyright © 2007 by The American Association for Thoracic Surgery.