Repair of an anomalous left coronary artery

Area of Science:

• Cardiology
• Congenital Heart Disease
• Interventional Cardiology

Background:

• Anomalous coronary arteries are rare congenital heart defects.
• Atypical chest pain can be a symptom of coronary artery anomalies.
• Diagnosis often requires advanced imaging like coronary angiography.

Observation:

• A patient presented with atypical chest pain due to an anomalous single coronary artery.
• Coronary angiography showed a single right coronary ostium.
• A narrowed left coronary artery originated from the right ostium and coursed within the aortic wall.

Findings:

• The anomalous coronary artery anatomy presented a unique surgical challenge.
• The left coronary artery's intramural course within the aortic wall was a critical finding.
• Successful surgical intervention was achieved using ostial remodeling.

Implications:

• Ostial remodeling is a viable surgical option for managing complex coronary artery anomalies.
• Understanding coronary artery origins is crucial for diagnosing and treating chest pain.
• This case highlights the importance of detailed coronary angiography in diagnosing rare cardiac conditions.