Anomalous Coronary Artery Origin and Course Between the Great Arteries: Report of Two Cases

Abstract

Anomalous coronary artery origin from the wrong aortic sinus, with or without coronary artery coursing between the aorta and the pulmonary artery, is a rare and dangerous anomaly that predisposes to potentially fatal episodes of myocardial ischemia upon exertion. We report here two cases of anomalous origin of a coronary artery with coronary compression between the aorta and the pulmonary artery. Both cases underwent successful surgical correction using the unroofing technique with creation of a new coronary orifice in the correct aortic sinus. A high level of suspicion is required to diagnose this malformation in children and young adults who present with exertional chest pain, and surgical correction is indicated in all cases once the diagnosis is established.