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Anomalous origin of the three major coronary arteries from a single common ostium

Biana Trost1, Leticia Fernandez-Friera, Javier Sanz

  • 1The Zena and Michael A. Weiner Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, USA. biana.trost@mssm.edu

The Journal of Invasive Cardiology
|October 15, 2010
PubMed

Insights

This study reports a rare coronary artery anomaly where the left anterior descending and right coronary arteries originated from a single ostium, with an absent left circumflex artery. This unique presentation highlights the diversity of congenital coronary variations.

Area of Science:

  • Cardiology
  • Anatomical Pathology

Background:

  • Coronary artery anomalies occur in approximately 1.3% of patients undergoing coronary angiography.
  • While often incidental, some anomalies, like interarterial courses, can cause significant symptoms including syncope and sudden death.

Observation:

  • A rare case of coronary artery anomaly involving a single ostium for the left anterior descending artery and right coronary artery, without a left main artery.
  • The left circumflex artery territory was supplied by a posterolateral/marginal branch originating from the right posterior descending artery and a conal branch.

Findings:

  • This represents a unique congenital coronary anomaly, distinct from previously reported cases of single ostium origins.
  • The absence of the left circumflex artery and its collateral supply via branches from the right coronary system is a novel finding.

Implications:

  • This case expands the known spectrum of coronary artery anomalies and their anatomical variations.
  • Understanding such rare anomalies is crucial for accurate diagnosis, risk stratification, and management in clinical cardiology.

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