Single coronary artery associated with perimembranous ventricular septal defect

The authors report the case of an adult male patient with a congenital ventricular septal defect who underwent an invasive assessment of his heart disease. Here, the septal defect was identified in the perimembranous area and a pulmonary-to-systemic flow ratio of 1.4:1 was calculated. At coronary angiography, a single coronary artery was found. This particular anomaly consisted of a proximal right coronary artery originating from a septal branch of the left anterior descending coronary artery and a distal right coronary artery arising from the distal left circumflex artery. Such an association constitutes an exceedingly rare congenital condition.