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[The single coronary artery. 2 clinical cases].
R Garbo1, G Steffenino, P Russo
1Dipartimento di Malattie Cardiovascolari, Azienda Ospedaliera S. Croce e Carle, Cuneo.
Summary
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.