[Off-pump coronary artery bypass grafting for single coronary artery; report of a case]

N Takemoto1, H Kuroda, K Ono

  • 1Department of Cardiovascular Surgery, Sanin Rosai Hospital, Yonago, Japan.

Insights

A rare coronary artery anomaly presented as angina pectoris. Surgical bypass grafting successfully treated the condition, restoring normal blood flow.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Anatomical Variations

Background:

  • A 55-year-old male presented with angina pectoris due to a single coronary artery anomaly.
  • Standard coronary arteriography failed to identify the left coronary orifice, necessitating detailed anatomical assessment.

Observation:

  • Right coronary arteriography revealed an unusual coronary artery anatomy.
  • The circumflex branch (Cx) coursed as the right coronary artery (RCA), and the left anterior descending (LAD) followed the Cx.
  • Significant 90% stenosis was noted in the posterior descending branch (#4PD) of the RCA.

Findings:

  • Off-pump coronary artery bypass grafting (CABG) was successfully performed.
  • The D1 artery was bypassed using a left internal thoracic artery graft.
  • The #4PD artery was revascularized with a radial artery graft.

Implications:

  • This case highlights the importance of thorough coronary imaging in complex anatomical variations.
  • Successful off-pump CABG demonstrates the feasibility of surgical intervention in anomalous coronary arteries.
  • Effective revascularization strategies can alleviate symptoms and improve outcomes for patients with rare coronary anomalies.