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J Thorac Cardiovasc Surg 2008;136:788-789
© 2008 The American Association for Thoracic Surgery

Brief Communication

Aberrant left coronary artery arising from the right sinus of Valsalva: Case reports of a rare entity

^a Department of Pediatric Cardiology, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium
^b Department of Cardiac Surgery, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium

Received for publication October 8, 2007; accepted for publication February 1, 2008.

^_* Address for reprints: Stéphane Moniotte, MD, PhD, Department of Pediatric Cardiology, Université Catholique de Louvain, 10 avenue Hippocrate, B1200 Brussels, Belgium. (Email: stephane.moniotte@uclouvain.be).

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

Among the clinically relevant congenital coronary malformations, origin from the wrong aortic sinus seems to be the most common in young trained athletes who die suddenly. The reported incidence is 0.92% for anomalous origin of the right coronary artery (RCA) from the left sinus and 0.15% for the left coronary artery (LCA) from the right sinus.¹ However, these data likely underestimate the true incidence of these abnormalities because these angiographic studies were presumably performed for other clinical indications. In a recent study of 6.3 million US Army recruits, Eckart and colleagues² reviewed the medical records of 277 nontraumatic deaths and found that 34% were the result of coronary anomalies. No coronary anomaly other than anomalous origin of the LCA from the right sinus of Valsalva was associated with cardiac death.

Clinical Summary

Patient 1
A previously healthy 2-year-old girl presented for evaluation of a murmur. Physical examination revealed stable vital signs, normal heart sounds, and a continuous murmur at the left sternal border. Electrocardiographic, radiographic, and laboratory findings were normal. Transthoracic echocardiography showed a patent ductus arteriosus, and an aberrant LCA from the right sinus of Valsalva was suspected.

Cardiac catheterization demonstrated a single coronary ostium from the right sinus of Valsalva, with the left main . . . [Full Text of this Article]

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