[HSF] anomolous RCA

[Tea Acuff]

I think it was an anomalous LAD.
Tea


----- Original Message ----
From: "dukeb60 at aol.com" <dukeb60 at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Tuesday, February 6, 2007 1:40:30 PM
Subject: Re: [HSF] anomolous RCA


Didn't Pete Maravich, the basketball star, die of an anomalous RCA playing pick-up basketball after his illustrious college and  hall of fame pro career?


-----Original Message-----
From: prasannasimha at gmail.com
To: OpenHeart-L at lists.hsforum.com
Sent: Mon, 5 Feb 2007 7:35 PM
Subject: Re: [HSF] anomolous RCA


An anomalous coronary vessel coursing between the aorta and RCA is known to cause sudden death during exertion. This is because of PA dilatation and compression during exercise and is well described in literature. 
This is an indication for a CABG. Usually a vein graft or a RIMA can be placed. If placing a RIMA graft it may string but I have seen them open up when proximal CAD has occurred. Incidentally that is what happened to Acar's radials over years which actually revived interest in radials. 
Prasanna 

Hgrmd at aol.com wrote: 
> Chand, 
> I wish I could show you the 64 slice CT scan. It clearly shows an RCA > arising from the left coronary sinus. It appears to be a string during its > course between the left side of the ascending aorta and the right side of the > MPA. Distally, it appears normal caliber and terminates in a nice PDA. I don't > see much of a posterolateral branch, and suspect it is a codominant system. > The LM, LAD, and Cx appear unremarkable. The radiologist interprets the scan > as an anomolous RCA with a "potentially lethal" anatomy. I've referred the > case to a cardiologist I trust and will get his opinion regarding the need > for a cath. Quite honestly, though I don't have much experience in > interpreting 64 slice scans, this appears to be an excellent study. The patient has had > exertional angina that began about a month ago. Interestingly, a nuclear > scan reveals mild anterior reversibility. > My initial plan is to place a RIMA to the RCA and probably close the RCA > at its
 course 
between the aorta and the PA. Looks to me that mobilizing the > RCA off the left sinus would be a dangerous royal pain. Any other suggestions? 
> Hal 
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