Percutaneous revascularization of anomalous left main coronary artery stenosis with a retro-aortic course

Area of Science:

• Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Congenital coronary artery anomalies are rare but can pose significant challenges in diagnosis and treatment.
• Anomalous origin of the left main coronary artery from the right sinus of Valsalva with a retro-aortic course is an uncommon variation.

Observation:

• A 54-year-old male presented with a rare coronary anomaly: a left main coronary artery originating from the right sinus with a retro-aortic course.
• A significant atherosclerotic lesion was identified in the distal left main coronary artery.

Findings:

• Successful percutaneous coronary intervention (PCI) with direct stenting was performed to address the atherosclerotic lesion.
• The intervention restored adequate blood flow, despite the complex anatomy.

Implications:

• This case highlights that percutaneous coronary intervention can be a safe and effective treatment for selected patients with complex coronary artery anomalies.
• Interventional cardiologists must be prepared to manage technically challenging cases involving coronary artery variations.