Surgical Treatment for Anomalous Aortic Origin of Coronary Arteries

: Anomalous aortic origin of coronary arteries is rare. We report 3 cases of surgical treatment for anomalous aortic origin of coronary arteries. Case 1 was a 38-year-old man who was saved by the use of an automated external defibrillator from cardiopulmonary arrest while exercising. The coronary angiogram showed the right coronary artery arising from the left coronary sinus of Valsalva and being located between the aorta and the pulmonary trunk. He underwent coronary artery bypass grafting (CABG) using the right internal thoracic artery with ligation of proximal part of right coronary artery to prevent sudden death. Case 2 was a 76-year-old woman with the left coronary artery arising from the right coronary sinus of Valsalva and proximal left anterior descending coronary artery stenosis. She underwent CABG. Case 3 was a 58-year-old man with severe aortic valve regurgitation. He underwent aortic valve replacement. During weaning from cardiopulmonary bypass, the electrocardiogram revealed ST-segment elevation. Transesophageal echocardiography showed intramural segment of the left coronary artery and obstruction of the left coronary blood flow. Repair was accomplished by unroofing the intramural segment. All the cases were successfully treated by surgical treatment.