Novel Beating Heart Repair for Anomalous Origin of Right Coronary Artery

Anomalous origin of the right coronary artery (ARCA) from the left coronary sinus is a rare anatomic anomaly. It may cause myocardial ischemia and sudden death. Several treatments have been tried, including coronary bypass grafting, unroofing, and reimplantation. These techniques, however, have disadvantages such as postoperative flow competition, aortic insufficiency, or kinks and angulation of the coronary artery, respectively. To overcome these problems, we undertook a novel approach: beating heart repair. It does not require aortic cross-clamping, cardioplegic arrest, aortotomy, or manipulation of the aortic commissure. Beating heart repair is a simple and effective procedure, which adds an ideal treatment option for ARCA.