Related Experiment Videos
[The single coronary artery. 2 clinical cases]
R Garbo1, G Steffenino, P Russo
1Dipartimento di Malattie Cardiovascolari, Azienda Ospedaliera S. Croce e Carle, Cuneo.
Insights
Single coronary artery is a rare congenital heart defect. Identifying its path relative to great vessels is crucial for prognosis, especially the interarterial course linked to sudden death.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Anatomy
Background:
- Single coronary artery (SCA) is a rare congenital anomaly where both coronary arteries originate from a single aortic ostium.
- The anatomical course of SCA relative to the great vessels is critical for determining prognosis.
Observation:
- Two cases of SCA are presented: one left-type SCA with an interarterial course identified using a Swan-Ganz catheter.
- A right-type SCA with a septal subtype and partial intramyocardial course was also observed.
Findings:
- The interarterial course of SCA, passing between the aorta and pulmonary trunk, carries the worst prognosis and is associated with sudden death.
- The septal subtype of right-type SCA, characterized by a partial intramyocardial course and a septal branch, has a good prognosis.
Implications:
- Accurate identification of SCA subtypes and their spatial relationship to great vessels is vital for risk stratification.
- Distinguishing between interarterial and intramyocardial courses aids in predicting patient outcomes and managing this rare congenital condition.
Abstract:
Single coronary artery is a rare congenital abnormality, characterized by a common origin of both right and left coronary arteries from a single aortic ostium. Recognizing the anatomic relationship between the single coronary artery and the great vessels is of prognostic importance: the variant in which the first part of the coronary artery passes between the aorta and the pulmonary trunk has the worst prognosis, and may be associated with sudden death during exercise. We describe 2 cases of single coronary artery: the first is of the more unusual left type, in which a Swan-Ganz catheter in the pulmonary artery helped to recognize the interarterial course subtype. The second case is a right type, belonging to the "septal" subtype, in which the left main trunk has a partial intramyocardial course: this variant has a good prognosis and can be distinguished from the "interarterial" subtype by the presence of a septal branch originating from the left main trunk.