Report of a case of the anomalous origin of the right coronary artery from the pulmonary artery with atrial fibrillation and bradycardia

: A 62-year-old man who was referred to implantation of pacemaker on account of severe bradycardia revealed anomalous origin of the right coronary artery from the pulmonary artery on aortography. The aortic root cineangiogram demonstrated single left coronary artery arising from the aorta with retrograde filling of the right coronary artery (RCA) which drained into the main pulmonary artery. Chest X-ray revealed marked cardiomegaly and treadmill exercise test shows positive at stage 2 of the Bruce protocol. Operation was performed under cardiopulmonary bypass. Although we tried to transplant the RCA to the aorta, the arterial wall was very fragile and could't bear arterial pressure. Therefore the RCA was ligated at its origin and disconnected from the pulmonary artery. Post operative course was uncomplicated and the patient was discharged without any symptoms.