{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:36Z","timestamp":1753876236805,"version":"3.41.2"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Anomalous coronary origin from the left ventricular outflow tract (LVOT) is an exceedingly rare condition thought to be associated with the bicuspid aortic valve (BAV). While the malignant presentation of this entity has been described, its pathophysiology and diagnostic evaluation are poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 33-year-old woman status post Ross procedure in childhood for congenital aortic stenosis due to BAV with presumed common origin of right and left coronary arteries based on single coronary ostium seen on aortic valve inspection, presented with symptomatic pulmonary regurgitation and stenosis. Invasive left coronary angiography revealed retrograde filling of the right coronary artery (RCA) with systolic washout of contrast indicating a patent RCA ostium. No RCA ostium was found on aortic root injection, but an injection into the LVOT revealed an RCA ostium below the aortic valve. Selective RCA angiography revealed pulsatile antegrade flow down the RCA occurring during systole. There was no anatomic RCA stenosis. We proceeded with valve-in-valve TcPVR. The patient had significant improvement of symptoms and RCA reimplantation was hence deferred.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case is the first of an anomalous coronary artery arising from the LVOT diagnosed in a patient after the Ross procedure. Our angiograms shed light on the unusual physiology of coronary filling during systole and ischaemia arising from inadequate perfusion gradient between the left ventricle and the coronary during systole, leading to collateralization despite the lack of anatomic stenosis. We urge consideration of this potentially malignant entity in any symptomatic patient, especially with concomitant BAV.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac237","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T14:24:20Z","timestamp":1655303060000},"source":"Crossref","is-referenced-by-count":0,"title":["Right coronary artery originating from the left ventricular outflow tract diagnosed after a Ross procedure: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4394-9828","authenticated-orcid":false,"given":"Prashanth","family":"Venkatesh","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson-UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine, University of California , Los Angeles, 200 Medical Plaza, Suite 202, Los Angeles, CA 90095 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3509-322X","authenticated-orcid":false,"given":"Weiyi","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson-UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine, University of California , Los Angeles, 200 Medical Plaza, Suite 202, Los Angeles, CA 90095 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-7162","authenticated-orcid":false,"given":"Katia","family":"Bravo-Jaimes","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson-UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine, University of California , Los Angeles, 200 Medical Plaza, Suite 202, Los Angeles, CA 90095 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0209-9505","authenticated-orcid":false,"given":"Jamil","family":"Aboulhosn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Ahmanson-UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine, University of California , Los Angeles, 200 Medical Plaza, Suite 202, Los Angeles, CA 90095 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"2022070817465613600_ytac237-B1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/BF00796821","article-title":"Congenital valvar aortic stenosis and abnormal origin of the right coronary artery: rare combination with important clinical implications","volume":"16","author":"Culbertson","year":"1995","journal-title":"Pediatr Cardiol"},{"key":"2022070817465613600_ytac237-B2","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1016\/j.athoracsur.2013.01.081","article-title":"Abnormal origin of right coronary artery from left ventricle with bicuspid aortic stenosis","volume":"96","author":"Kang","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2022070817465613600_ytac237-B3","first-page":"162","article-title":"Ectopic origin of left coronary ostium from left ventricle, with occlusive membrane: a previously unreported anomaly, with an embryologic interpretation","volume":"35","author":"Pirelli","year":"2008","journal-title":"Tex Heart Inst J"},{"key":"2022070817465613600_ytac237-B4","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/jocs.13173","article-title":"Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract with a retro-aortic collateral vessel","volume":"32","author":"Khan","year":"2017","journal-title":"J Card Surg"},{"key":"2022070817465613600_ytac237-B5","first-page":"931","article-title":"Sudden death in a young athlete due to an anomalous commissural origin of the left coronary artery, and focal intimal proliferation of aortic valve leaflet at the adjacent commissure","volume":"118","author":"Land","year":"1994","journal-title":"Arch Pathol Lab Med"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac237\/44080776\/ytac237.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/7\/ytac237\/44608198\/ytac237.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/7\/ytac237\/44608198\/ytac237.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T17:47:31Z","timestamp":1657302451000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac237\/6608725"}},"subtitle":[],"editor":[{"given":"Sylvia","family":"Krupickova","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Maria Antonieta Albanez A","family":"de Medeiros Lopes","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Pruthvi","family":"C Revaiah","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Zhiyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Fabienne","family":"Vervaat","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,15]]},"references-count":5,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac237","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2022,7,1]]},"published":{"date-parts":[[2022,6,15]]},"article-number":"ytac237"}}