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Case Reports
. 2010 Oct;26(8):326-7.
doi: 10.1016/s0828-282x(10)70445-1.

Robotic coronary artery bypass for aberrant right coronary artery stenosis

Kuan-chin Jean Chen  1 , Patrick Teefy, Bob Kiaii, William C Vezina, Michael Wa Chu
Affiliations
Case Reports

Robotic coronary artery bypass for aberrant right coronary artery stenosis

Kuan-chin Jean Chen et al. Can J Cardiol. 2010 Oct.

Abstract
in English, French

Anomalous coronary arteries that course between the aorta and pulmonary artery are subject to compressive forces and can manifest angina, myocardial infarction and sudden death. The current report presents a young, female patient who presented with a short duration of severe, rapidly progressive angina despite optimal medical therapy. Combined computed tomography and myocardial perfusion scanning identified an anomalous dominant right coronary artery that appeared kinked at its origin between the aorta and main pulmonary artery. A robot-assisted right internal thoracic artery to right coronary artery bypass was performed, which was confirmed to be widely patent (FitzGibbon grade A) on routine intraoperative angiography. The procedure completely resolved the patient's angina symptoms.

Des artères coronaires anormales situées entre l’aorte et l’artère pulmonaire sont soumises à des forces compressives et peuvent provoquer de l’angine, un infarctus du myocarde et une mort subite. Le présent rapport présente une jeune femme qui a consulté à cause d’une grave angine de fraîche date à évolution rapide malgré une pharmacothérapie optimale. La tomodensitométrie associée à la scintigraphie myocardique de perfusion a permis de repérer une artère coronaire droite dominante anormale dont l’origine semblait coudée entre l’aorte et la principale artère pulmonaire. Un pontage coronarien de l’artère thoracique interne droite assistée par robot en a confirmé la perméabilité (score A de FitzGibbon) lors l’angiographie intraopératoire systématique. L’intervention a complètement résorbé les symptômes d’angine de la patiente.

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Figures

Figure 1)
Figure 1)
A Computed tomography demonstrating ‘kinked’ anomalous origin of the right coronary artery (RCA). B Intraoperative angiogram demonstrating a widely patent right internal thoracic artery to RCA anastomosis (arrow). AO Aorta; PA Pulmonary artery
Figure 2)
Figure 2)
Photograph of incisional scar at the two-month postoperative follow-up
See this image and copyright information in PMC

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