日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Anomalous right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital heart disease. Our patient was a 1 year and 2 months old Japanese girl who was diagnosed based on cardiac echocardiography findings during follow-up for failure to thrive. The echocardiography showed a slightly larger left main coronary artery, the origin of the right coronary artery was not clearly detected, and color Doppler showed multiple blood flow signals in the ventricular septum. Coronary CT showed that the right coronary artery originated from the main pulmonary artery, confirming the diagnosis of ARCAPA. Left coronary artery angiography by cardiac catheterization showed that contrast medium flowed from the left coronary artery into the right coronary artery via the collateral vessels, and the main pulmonary artery was contrasted. Multiple blood flow signals in the ventricular septum on echocardiography were observed to be collateral blood vessels from the left coronary artery to the right coronary artery. ARCAPA can cause myocardial infarction and sudden death, and in this case, the right coronary artery was re-implanted into the aorta. Echocardiography was useful in the diagnosis of this disease with its characteristic findings.