Proximal ligation in coronary artery bypass grafting for anomalous origin of right coronary artery: A case series with transit-time flow measurement

Anomalous aortic origin of the right coronary artery (AAoRCA) is a rare anomaly associated with sudden cardiac death, especially with an interarterial course. Coronary artery bypass grafting (CABG) is a treatment option, but graft occlusion from competitive native flow is a concern. In our series, transit-time flow measurement often showed systolic reverse flow, which disappeared after proximal right coronary artery ligation. Coronary artery bypass grafting achieved excellent long-term outcomes. These findings suggest CABG is a suitable treatment for AAoRCA, particularly when proximal ligation is appropriately performed.