Circulation, Vol 59, 748-754, Copyright © 1979 by American Heart Association
RR Liberthson, RE Dinsmore and JT Fallon
To clarify the natural history and management of patients with aberrant
origin of a coronary artery from the aorta, we reviewed 18 patients whose
right (RCA) or left (LCA) coronary artery arose aberrantly and passed
between the aorta and right ventricular infundibulum. Nine patients had
aberrant LCA. Three young males died suddenly after exertion, each with
proximal focal LCA stenosis. None of the six adults with angina (ages 36-70
years) studied angiographically had proximal LCA stenosis. Unlike the
young, "sudden death-prone" patients in whom coronary bypass of proximal
stenosis may have prophylactic value, our older patients with aberrant LCA
did not have proximal stenosis or sudden death, and therefore LCA bypass
for sudden death prophylaxis is not warranted. Nine patients (ages 18-60
years) had aberrant origin and course of the RCA. Seven patients studied
angiographically because of angina had no focal proximal RCA stenosis, but
two patients had hypoplastic RCA ostia. Although a potential concern in
these latter patients, sudden death has not been reported with aberrant
RCA, therefore in the absence of syncope, RCA bypass for sudden death
prophylaxis is not indicated.
ARTICLES
Aberrant coronary artery origin from the aorta. Report of 18 patients, review of literature and delineation of natural history and management
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