Primary percutaneous coronary intervention of an anomalous right coronary artery arising from the left coronary cusp

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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)
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

J Chris Matchison1, David M Shavelle

  • 1Division of Cardiology, Los Angeles BioMedical Research Institute, Harbor-UCLA Medical Center, Torrance, California, USA.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|April 6, 2012
PubMed

Insights

A rare case of acute myocardial infarction caused by an anomalous right coronary artery originating from the left coronary cusp was successfully treated with percutaneous coronary intervention, highlighting effective management strategies.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Anomalous origin of the coronary arteries is a rare congenital condition.
  • Right coronary artery anomalies originating from the contralateral sinus of Valsalva are uncommon.
  • Occlusion of such anomalies can lead to myocardial infarction.

Observation:

  • A 66-year-old male presented with acute inferior wall myocardial infarction.
  • The infarction was attributed to occlusion of an anomalous right coronary artery arising from the left coronary cusp.
  • An undersized Judkins left guide catheter was utilized for intervention.

Findings:

  • Primary percutaneous coronary intervention was successfully performed for the anomalous coronary artery.
  • Computed tomographic angiography confirmed the anomalous origin and course of the right coronary artery.
  • Post-intervention assessment confirmed coronary stent patency.

Implications:

  • This case demonstrates the feasibility of percutaneous coronary intervention for managing myocardial infarction secondary to anomalous coronary artery origin.
  • Accurate anatomical characterization using computed tomographic angiography is crucial for guiding intervention.
  • Successful revascularization can lead to favorable outcomes in patients with complex coronary anomalies.

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