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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Single coronary artery arising from the right sinus of Valsalva

Hülya Ciçekçioğlu1, Ozgül Uçar, Nuri Küpelikilinç

  • 1Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|August 3, 2010
PubMed

Insights

Single coronary artery (SCA) is a rare congenital anomaly diagnosed in a 65-year-old male presenting with new-onset exertional angina. Coronary angiography confirmed SCA type R-IIA, with the left coronary artery coursing anteriorly, and a nonobstructive lesion in the LCx artery.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Medical Imaging

Background:

  • Single coronary artery (SCA) is a rare congenital anomaly with varied clinical presentations.
  • Understanding SCA anatomy is crucial for diagnosing and managing associated cardiovascular conditions.

Observation:

  • A 65-year-old male with diabetes, hypertension, and hyperlipidemia presented with new-onset exertional angina.
  • Initial investigations including ECG and echocardiogram were normal; treadmill test was limited by fatigue.
  • Coronary angiography revealed a single coronary artery (SCA) of type R-IIA originating from the right sinus of Valsalva.

Findings:

  • The left coronary artery (LCA) exhibited an anterior course anterior to the right ventricular outflow tract.
  • Branches for the left anterior descending and left circumflex (LCx) arteries originated from the LCA.
  • A mild, nonobstructive atherosclerotic lesion was identified in the LCx artery.
  • 16-row multislice computed tomography provided detailed visualization of the SCA anatomy and LCA course.

Implications:

  • This case highlights the importance of considering SCA in patients with unexplained angina, even with normal initial non-invasive tests.
  • The anatomical course of the LCA in SCA can influence surgical or interventional strategies.
  • Management focused on medical therapy and risk factor modification due to nonobstructive disease.

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