{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T04:14:11Z","timestamp":1744949651285,"version":"3.40.4"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"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":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Coronary artery origin anomalies, though often incidentally detected, can lead to sudden death. Comprehensive perioperative management is essential. We report a case of an anomalous right coronary artery (RCA) arising from the left main coronary artery (LMCA) and coursing between the aorta and pulmonary artery, discovered after myocardial infarction, in which intraoperative management ensured successful coronary reconstruction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 49-year-old woman presented with chest pain and ST segment elevation. Coronary angiography revealed an anomalous RCA demonstrating compressive ischemia by the aorta and pulmonary artery. Preoperatively, blood pressure was stabilized with an isosorbide dinitrate patch. Under cardiopulmonary bypass, the RCA was transected and reanastomosed to its physiological aortic position. Intraoperatively, nicorandil was administered to suppress vascular smooth muscle contraction, while five-lead ECG, transesophageal echocardiography, and operative ultrasound monitoring enabled early detection of ischemia and prevented hypertension. Postoperative ventricular premature contractions resolved by the next day, with uneventful recovery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Targeted pharmacologic blood pressure control and multimodal monitoring are vital for safe perioperative outcomes in anomalous coronary artery origin cases.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40981-025-00786-9","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T12:46:32Z","timestamp":1744893992000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anesthetic management of coronary artery reconstruction in a patient with myocardial ischemia caused by an anomalous origin of the right coronary artery running between the great vessels: a case report"],"prefix":"10.1186","volume":"11","author":[{"given":"Riki","family":"Kuzuno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-0855","authenticated-orcid":false,"given":"Shuji","family":"Kawamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Tatsumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikashi","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritoki","family":"Egi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"786_CR1","doi-asserted-by":"publisher","first-page":"122","DOI":"10.9794\/jspccs.32.122","volume":"32","author":"Y Imoto","year":"2016","unstructured":"Imoto Y. Surgical treatment of coronary artery anomalies. Pediatr Cardiol Cardiac Surg. 2016;32:122\u20138.","journal-title":"Pediatr Cardiol Cardiac Surg"},{"key":"786_CR2","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1161\/01.CIR.94.4.850","volume":"94","author":"BJ Maron","year":"1996","unstructured":"Maron BJ, Thompson PD, Puffer JC, McGrew CA, Strong WB, Douglas PS, et al. Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young) American Heart Association. Circulation. 1996;94:850\u20136.","journal-title":"Circulation."},{"key":"786_CR3","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1016\/j.jtcvs.2011.08.056","volume":"144","author":"CR Bartoli","year":"2012","unstructured":"Bartoli CR, Wead WB, Giridharan GA, Prabhu SD, Koenig SC, Dowling RD. Mechanism of myocardial ischemia with an anomalous left coronary artery from the right sinus of Valsalva. J Thorac Cardiovasc Surg. 2012;144:402\u20138.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"786_CR4","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1002\/ccd.1810210110","volume":"21","author":"O Yamanaka","year":"1990","unstructured":"Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990;21:28\u201340.","journal-title":"Cathet Cardiovasc Diagn"},{"key":"786_CR5","doi-asserted-by":"publisher","first-page":"e027098","DOI":"10.1161\/JAHA.122.027098","volume":"11","author":"MR Bigler","year":"2022","unstructured":"Bigler MR, Kadner A, R\u00e4ber L, Ashraf A, Windecker S, Siepe M, 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. 2022;11:e027098.","journal-title":"J Am Heart Assoc"},{"key":"786_CR6","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1016\/j.jtcvs.2019.02.122","volume":"158","author":"A Jegatheeswaran","year":"2019","unstructured":"Jegatheeswaran A, Devlin PJ, McCrindle BW, Williams WG, Jacobs ML, Blackstone EH, et al. Features associated with myocardial ischemia in anomalous aortic origin of a coronary artery: a Congenital Heart Surgeons\u2019 Society study. J Thorac Cardiovasc Surg. 2019;158:822-34.e3.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"11\u201312","key":"786_CR7","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.acvd.2010.01.010","volume":"103","author":"F Barbou","year":"2010","unstructured":"Barbou F, Schiano P, Lahutte M. Anomalous right coronary artery from the left coronary sinus, with an interarterial course. Arch Cardiovasc Dis. 2010;103(11\u201312):626\u20138.","journal-title":"Arch Cardiovasc Dis."},{"issue":"1","key":"786_CR8","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.jtcvs.2017.08.116","volume":"155","author":"CM Mery","year":"2018","unstructured":"Mery CM, De Le\u00f3n LE, Molossi S, Sexson-Tejtel SK, Agrawal H, Krishnamurthy R, Masand P, et al. Outcomes of surgical intervention for anomalous aortic origin of a coronary artery: a large contemporary prospective cohort study. J Thorac Cardiovasc Surg. 2018;155(1):305-319.e4.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"786_CR9","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1111\/jocs.14234","volume":"34","author":"WI Ibraheem","year":"2019","unstructured":"Ibraheem WI, Abass OA, Toema AM, Yehia AM. Coronary artery bypass grafting experience in the setting of an anomalous origin of the right coronary artery from the left sinus of Valsalva: midterm results. J Card Surg. 2019;34:1162\u201371.","journal-title":"J Card Surg"},{"key":"786_CR10","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.jtcvs.2006.10.011","volume":"133","author":"LM Fedoruk","year":"2007","unstructured":"Fedoruk LM, Kern JA, Peeler BB, Kron IL. Anomalous origin of the right coronary artery: right internal thoracic artery to right coronary artery bypass is not the answer. J Thorac Cardiovasc Surg. 2007;133:456\u201360.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00786-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-025-00786-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00786-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T12:46:32Z","timestamp":1744893992000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-025-00786-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["786"],"URL":"https:\/\/doi.org\/10.1186\/s40981-025-00786-9","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,17]]},"assertion":[{"value":"7 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent was obtained from the patient for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21"}}