Case Report
Inafuku H, Kuniyoshi Y, Yamash
Abstract
An anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenitalcoronary artery malposition. We describe its surgical re-implantation in a 49-year-old man with marked dilatation ofboth coronary arteries. We decided to perform surgery based on intraoperative esophageal echocardiographicfindings, 15 min after clamping the right coronary artery at its origin. Re-implantation from the main pulmonary arteryto the ascending aorta was performed successfully. The dilated left coronary artery had diminished in size.Pathological findings of the excised proximal arterial wall of the ARCAPA showed much amount of elastic fibers inthe arterial wall as an elastic artery thought to have originated from the pulmonary trunk.