{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:13:04Z","timestamp":1790097184540,"version":"4.0.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T00:00:00Z","timestamp":1720828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T00:00:00Z","timestamp":1720828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>An anomalous origin and inter-arterial course of the right coronary artery is a rare anomaly that can lead to sudden ischemic cardiac death if left untreated. We present a case of a patient with an anomalous right coronary artery originating from the left coronary sinus and an inter-arterial course that was managed with coronary artery bypass surgery using a suitable internal mammary artery conduit. The proximal right coronary artery was ligated to prevent competitive flow.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case Presentation<\/jats:title>\n                <jats:p>A 69 year-old-male with a ten-year history of intermittent chest pain and dyspnea with a negative workup underwent a cardiac catheterization, which showed an anomalous right coronary artery (RCA) originating from the left coronary sinus, with an inter-arterial course between the ascending aorta and pulmonary artery, and approximately 70% narrowing of the proximal RCA. The patient underwent an on-pump coronary artery bypass using the right internal mammary artery (RIMA) as a conduit, with segment 2 of the RCA being the target. The proximal RCA was ligated. Intra-operatively, there were no signs of ischemia or arrhythmia. The patient was successfully taken off cardiopulmonary bypass and eventually discharged home.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Symptomatic anomalous origin of the right coronary artery with an inter-arterial course can be treated successfully with coronary artery bypass surgery with the internal mammary artery as a conduit. Ligation of the proximal right coronary artery is essential to minimize competitive flow through the bypass graft.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02896-4","type":"journal-article","created":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T06:02:22Z","timestamp":1720850542000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Anomalous right coronary artery managed with bypass and proximal ligation"],"prefix":"10.1186","volume":"19","author":[{"given":"Harry","family":"Ramcharran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Nazem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,13]]},"reference":[{"key":"2896_CR1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ijscr.2015.07.018","volume":"14","author":"S Fuglsang","year":"2015","unstructured":"Fuglsang S, Heiberg J, Byg J, Hjortdal VE. Anomalous origin of the right coronary artery with an interarterial course and intramural part. Int J Surg Case Rep. 2015;14:92\u20134. https:\/\/doi.org\/10.1016\/j.ijscr.2015.07.018.","journal-title":"Int J Surg Case Rep"},{"issue":"6","key":"2896_CR2","doi-asserted-by":"publisher","first-page":"e111","DOI":"10.1161\/CIRCEP.112.978635","volume":"5","author":"B Greet","year":"2012","unstructured":"Greet B, Quinones A, Srichai M, Bangalore S, Roswell RO. Anomalous right coronary artery and sudden cardiac death. Circ Arrhythm Electrophysiol Dec. 2012;5(6):e111\u20132. https:\/\/doi.org\/10.1161\/CIRCEP.112.978635.","journal-title":"Circ Arrhythm Electrophysiol Dec"},{"issue":"22","key":"2896_CR3","doi-asserted-by":"publisher","first-page":"e022377","DOI":"10.1161\/JAHA.121.022377","volume":"16","author":"L Gharibeh","year":"2021","unstructured":"Gharibeh L, Rahmouni K, Hong SJ, Crean AM, Grau JB. Surgical techniques for the treatment of anomalous origin of right coronary artery from the left sinus: a comparative review. J Am Heart Assoc Nov. 2021;16(22):e022377. https:\/\/doi.org\/10.1161\/JAHA.121.022377.","journal-title":"J Am Heart Assoc Nov"},{"key":"2896_CR4","doi-asserted-by":"publisher","unstructured":"Grani C, Kaufmann PA, Windecker S, Buechel RR. Diagnosis and management of anomalous coronary arteries with a malignant course. Interv Cardiol. May 2019;14(2):83\u20138. https:\/\/doi.org\/10.15420\/icr.2019.1.1.","DOI":"10.15420\/icr.2019.1.1"},{"issue":"1","key":"2896_CR5","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1186\/s13256-023-03921-1","volume":"10","author":"P Arun Kumar","year":"2023","unstructured":"Arun Kumar P, Patel B, Dasari M, Bhattad PB, Prabhu S, Hadley M. Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report. J Med Case Rep May. 2023;10(1):191. https:\/\/doi.org\/10.1186\/s13256-023-03921-1.","journal-title":"J Med Case Rep May"},{"issue":"12","key":"2896_CR6","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1161\/CIRCULATIONAHA.121.055347","volume":"21","author":"F Gentile","year":"2021","unstructured":"Gentile F, Castiglione V, De Caterina R. Coronary artery anomalies. Circulation Sep. 2021;21(12):983\u201396. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.121.055347.","journal-title":"Circulation Sep"},{"issue":"6","key":"2896_CR7","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","volume":"11","author":"H Baumgartner","year":"2021","unstructured":"Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J Feb. 2021;11(6):563\u2013645. https:\/\/doi.org\/10.1093\/eurheartj\/ehaa554.","journal-title":"Eur Heart J Feb"},{"issue":"1","key":"2896_CR8","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1186\/s12872-020-01486-1","volume":"22","author":"S Pradhan","year":"2020","unstructured":"Pradhan S, Gresa K, Trappe HJ. Anomalous right coronary artery with interarterial course depicting an unusual case of an electrical storm: a case presentation. BMC Cardiovasc Disord Apr. 2020;22(1):192. https:\/\/doi.org\/10.1186\/s12872-020-01486-1.","journal-title":"BMC Cardiovasc Disord Apr"},{"issue":"20","key":"2896_CR9","doi-asserted-by":"publisher","first-page":"e027098","DOI":"10.1161\/JAHA.122.027098","volume":"18","author":"MR Bigler","year":"2022","unstructured":"Bigler MR, Kadner A, Raber L, et al. Therapeutic management of anomalous coronary arteries originating from the Opposite Sinus of Valsalva: current evidence, proposed Approach, and the Unknowing. J Am Heart Assoc. Oct 2022;18(20):e027098. https:\/\/doi.org\/10.1161\/JAHA.122.027098.","journal-title":"J Am Heart Assoc"},{"issue":"4","key":"2896_CR10","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1093\/ejcts\/ezr064","volume":"41","author":"D Glineur","year":"2012","unstructured":"Glineur D, Hanet C. Competitive flow and arterial graft a word of caution. Eur J Cardiothorac Surg Apr. 2012;41(4):768\u20139. https:\/\/doi.org\/10.1093\/ejcts\/ezr064.","journal-title":"Eur J Cardiothorac Surg Apr"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02896-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02896-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02896-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T06:02:40Z","timestamp":1720850560000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02896-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,13]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2896"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02896-4","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,13]]},"assertion":[{"value":"4 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent to publish this case report was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"439"}}