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Coexisting Congenital Left and Right Coronary Artery Anomalies

Year: 2025

Type: article

Abstract: BACKGROUND: Congenital left main coronary artery atresia (LMCAA) is an extremely rare anomaly associated with a high risk of myocardial ischemia and sudden cardiac arrest. CASE SUMMARY: We present the case of a 12-year-old boy who experienced a ventricular fibrillation arrest during exercise, primarily attributed to LMCAA with an anomalous right coronary artery (RCA) originating from the left aortic sinus considered as the potential contributing factor. Multimodal imaging was critical in diagnosis and surgical planning. The patient underwent successful surgical revascularization with left internal mammary artery grafting to the left anterior descending artery and unroofing of the anomalous RCA. DISCUSSION: In children presenting with out of hospital cardiac arrest, accurate imaging for coronary artery anomalies remains paramount. The diagnosis of congenital LMCAA with an anomalous RCA (with high-risk features) represents a rare but potentially treatable cause. TAKE-HOME MESSAGE: The case underscores the importance of early recognition and intervention in rare congenital coronary artery anomalies.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105290

Authors: Samir Bhatia, Matthew Liava'a, Julian Ayer, Claire M. Lawley

Institutions: Children's Hospital at Westmead, Sydney Children’s Hospitals Network, The University of Sydney, Sydney Children's Hospital

Language: English

Topic: Coronary Artery Anomalies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850