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(Circulation. 1968;37:244.)
© 1968 American Heart Association, Inc.

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Correction of Shunt from Right Conal Coronary Artery to Pulmonary Trunk with Relief of Symptoms

GERALD B. LEE M.D.¹; FREDARICK L. GOBEL M.D.¹; C. WALTON LILLEHEI M.D.¹; WALTER S. NEFF M.D.¹; ROBERT S. ELIOT M.D.¹

¹ From the Departments of Medicine and Surgery, University of Minnesota Hospitals, Minneapolis, Minnesota.

A case of a small right coronary conal branch to pulmonary trunk shunt with surgical correction is reported. The patient, a 45-year-old housewife, had chest pain, labile hypertension, and intermittent left bundle-branch block with normal serum cholesterol and triglyceride levels. Selective coronary arteriography was necessary to demonstrate the abnormal communication between the conal branch of the right coronary artery and the pulmonary trunk. Symptoms disappeared after surgical correction of the shunt. Transient left bundle-branch block appeared during exercise after surgery, but the patient was improved subjectively and resumed all household chores without difficulty. Shunting of oxygenated blood away from the myocardium thereby decreasing coronary blood flow to a specific area may have been responsible for significant symptomatology.

Key Words: Coronary arteriovenous fistula • Coronary arteriography • Conus artery • Angina pectoris

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