Anomalous High Origin of the Right Coronary Artery

The ostium of the right coronary artery is normally located on the right aortic sinus. A rare abnormality is a high origin above the sinotubular junction (arrows). This anomaly has been reported in association with ventricular septal defect and patent ductus arteriosus (not present in our patient).

If the abnormal artery travels between aorta and right ventricular outflow tract, there is a risk of acute myocardial infarction or sudden death. It is also important to note this finding to avoid inadvertent ligation during surgery. Anomalous high origin of the right coronary artery may also be associated with unsuccessful induction of cardiac arrest by cardioplegia.

References

• Alpaslan M, Onrat E. Anomalous origin of right coronary artery above the sinus of Valsalva: observation by transthoracic echocardiography. J Am Soc Echocardiogr. 2002 Mar;15(3):264-6.
• Tarhan A, Kehlibar T, Yilmaz M, Arslan Y, Pancaroglu C, Yigit S, Ozler A. Right coronary artery with high takeoff. Ann Thorac Surg. 2007 May;83(5):1867-9.