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Cardiac Imaging Findings in Anomalous Origin of the Coronary Arteries From the Pulmonary Artery; Narrative Review of the Literature Publisher



Ajam A1 ; Rahnamoun Z2 ; Sahebjam M2 ; Sattartabar B1, 4 ; Razminia Y1 ; Ahmadi Tafti SH1, 3 ; Hosseini K1
Authors
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Authors Affiliations
  1. 1. Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Echocardiography, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Echo Research and Practice Published:2022


Abstract

Introduction: Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare coronary artery malformation with an incidence of 0.002% in patients undergoing coronary angiography. It can lead to an increased risk of myocardial infarction (MI) and sudden cardiac death, even in asymptomatic patients. Methods: We conducted a review of published cases of ARCAPA using PubMed and Scopus databases and included patients over 18 years old with adequate echocardiographic data. Results: We evaluated 28 patients with ARCAPA with a mean age of 42.8 from 1979 to 2021. Patients were diagnosed mostly by angiography and echocardiography, the most performed treatment was reimplantation (15, 53.6%) and the main echocardiographic findings were dilated coronary arteries (9, 32.1%), coronary collaterals (8, 28.6%), and retrograde flow from right coronary arteries to main pulmonary trunk (7, 25%). Conclusion: Although ARCAPA is rare and not as deadly as the anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) still there is a chance of serious outcomes, therefore surgical treatment should be performed upon diagnosis. Angiography is the gold standard for diagnosis, but echocardiography can be a convenient, non-invasive, and most reliable method as the primary step whenever ARCAPA is suspected. © 2022, The Author(s).