Translocation of the Right Coronary Artery Orifice for Right Coronary Artery Compression

Abstract

We report two cases of surgery for right coronary artery compression between the ascending aorta and the main pulmonary artery. The first case, a 48-year-old male who developed signs and symptoms of right coronary artery ischemia, was evaluated by computed tomography scan of the chest, cinecardioangiogram, and coronary arteriogram. Anomalous origin of the right coronary artery with compression of the proximal coronary artery was documented and the patient underwent translocation of the right coronary artery orifice to the anterior aspect of the ascending aorta. The postoperative course was uneventful. The second case, a 67-year-old female with calcific aortic stenosis, underwent cinecardioangiogram, and coronary arteriogram. Anomalous origin of the right coronary artery with proximal right coronary artery compression was identified. The symptoms could not be distinguished from her symptomatic calcific aortic stenosis, however, at the time of surgery, significant compression against the proximal right coronary artery was noticed. Translocation of the right coronary artery orifice and aortic valve replacement were performed. This patient's recovery was also uneventful. In view of the excellent results in both cases, we recommend translocation of the right coronary artery orifice to the anterior aspect of the ascending aorta for this type of anomaly.