Anomalous Coronary Artery From the Wrong Sinus of Valsalva: A Physiologic Repair Strategy

Nelson Alphonso, Petros V. Anagnostopoulos, Lars Nölke, Anita Moon-Grady, Anthony Azakie, Gary W. Raff, Tom R. Karl

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Background: A coronary artery arising from the wrong aortic sinus, with or without a proximal course between the aorta and the pulmonary artery, may predispose to myocardial ischemia, myocardial infarction, or sudden death. Methods: We repaired this lesion in 5 symptomatic patients, all of whom had experienced exercise-related chest pain, dyspnea, or syncopal episodes. All patients underwent patch angioplasty of the proximal anomalous coronary artery with glutaraldehyde-treated autologous pericardium. When the coronary artery coursed between the aorta and the main pulmonary artery, the main pulmonary artery was translocated toward the left pulmonary artery to create additional space and prevent compression. Results: All patients recovered well and to date have demonstrated no evidence of recurrent myocardial ischemia. Conclusions: The combination of coronary artery angioplasty and translocation of the pulmonary artery seems to effectively address all the mechanisms that can generate ischemia.

Original languageEnglish (US)
Pages (from-to)1472-1476
Number of pages5
JournalAnnals of Thoracic Surgery
Issue number4
StatePublished - Apr 2007


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