Intervention of stenosed right coronary artery and anomalous left main coronary artery: single main coronary trunk

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Biology

Background:

• Anomalous origin of the left main coronary artery from the right coronary artery is a rare congenital coronary anomaly.
• Stenosis in such anomalous vessels can lead to significant ischemic events.
• Complex bifurcating lesions pose technical challenges for revascularization.

Observation:

• An 86-year-old female presented with stenosis of an anomalous left main trunk.
• The anomalous left main trunk originated from a stenosed ostial right coronary artery.
• The lesion involved a complex bifurcation requiring advanced intervention.

Findings:

• Successful percutaneous coronary intervention (PCI) was performed.
• The PCI utilized simultaneous sirolimus-eluting kissing stents (SKS).
• This approach effectively addressed the anomalous bifurcating lesions.

Implications:

• Kissing stent techniques can be effective for complex bifurcations in anomalous coronary anatomy.
• PCI with drug-eluting stents offers a viable treatment option for selected cases of anomalous coronary artery stenosis.
• This case highlights the importance of individualized treatment strategies for rare coronary anomalies.