Anomalous Right Coronary Artery 

This video is part of Dr. Vince Gaudiani’s Anomalous Right Coronary Artery Series. View more videos from this series here.  

This video demonstrates a case involving an anomalous right coronary artery (RCA). The patient, a man who collapsed at an amusement arcade, had an anomalous vessel discovered after resuscitation. He also presented with a large aorta.  

The procedure began with a hemisternotomy.  The aorta was marked to indicate the location for reimplantation of the RCA. After marking, the aorta was cross-clamped, and the RCA vessel was identified. The RCA was dissected as closely as possible to the aorta, and a Dacron suture was placed around the vessel to tie off the origin from the aorta. The RCA was then divided, revealing a small RCA, which was mobilized.  

Due to a less-than-optimal view, Dr. Gaudiani converted the case to a full sternotomy, which improved visibility. The RCA was pulled up to the aorta, and a new location for the RCA was identified. The aorta was punched to make a hole in it, and the RCA was then anastomosed to the distal aorta, completing the case.  

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