Anomalous origin of single coronary artery in association with pulmonary atresia

Successful surgical treatment for a single coronary artery arising from the pulmonary artery

The case of a 17-day-old infant who underwent correction of an aortic coarctation with pulmonary artery banding for ventricular septal defect is reported. Ischemic cardiac failure 3 weeks later led the authors to diagnose a single coronary artery originating from the pulmonary artery. At the age of 2 months, the infant underwent successful reimplantation of the coronary artery onto the ascending aorta and surgical closure of the septal defect. Normalization of the left ventricular function was observed at the 2-year follow-up assessment.

Vascular aneurysm producing divided right atrium in a patient with pulmonary atresia and intact ventricular septum

We describe a patient with pulmonary atresia and intact ventricular septum in whom the right atrium was divided by a vascular aneurysm located in the right atrioventricular groove. We postulate that the structure represents an aneursymally dilated right coronary artery taking anomalous origin from the pulmonary trunk, with fistulous communication to the right atrium. We discuss the findings relative to concepts of development of the coronary arteries in normal hearts and in pulmonary atresia with an intact ventricular septum.

Three anomalies of the coronary arteries co-existing in a case of pulmonary atresia with intact ventricular septum

A female infant, who died 17 hours after spontaneous birth, was found to have three distinct coronary arterial anomalies in association with pulmonary atresia with intact ventricular septum. These anomalies were first, an aneurysmal left coronary artery with a fistulous communication into the right ventricle; second, an anomalous origin of the right coronary artery from the pulmonary artery; and third, a supernumerary coronary artery arising from the right ventricle. Although the coronary arterial system was entirely connected to the right ventricle, the perfusing blood originated from the left ventricle and there was no clinical or histological evidence of significant myocardial ischaemia.