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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 anomaly: Report of an extremely rare variation

Arash Gholoobi1, Hoorak Poorzand1

  • 1Atherosclerosis Prevention Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Asian Cardiovascular & Thoracic Annals
|December 19, 2015
PubMed

Insights

A rare single coronary artery anomaly presented with unstable angina. Treatment involved stenting the anomalous right coronary artery, with the patient remaining symptom-free, suggesting the anomaly itself doesn't accelerate atherosclerosis.

Area of Science:

  • Cardiology
  • Congenital Heart Disease

Background:

  • Coronary artery anomalies are rare congenital conditions.
  • Unstable angina necessitates thorough coronary evaluation.

Observation:

  • A 43-year-old male presented with unstable angina.
  • Coronary angiography revealed a single coronary artery arising from the left sinus of Valsalva.
  • This artery trifurcated into the left anterior descending, left circumflex, and an anomalous right coronary artery with a retroaortic course.

Findings:

  • The anomalous right coronary artery exhibited significant proximal tubular stenosis.
  • Stenting of the stenotic segment was performed.
  • Transesophageal echocardiography confirmed the coronary anomaly and its retroaortic path.
  • The patient was asymptomatic at one-year follow-up.

Implications:

  • This specific coronary anomaly does not appear to predispose to accelerated atherosclerosis.
  • Premature atherosclerosis in this case was likely linked to lifestyle factors rather than the congenital anomaly.
  • Management of coronary artery anomalies requires individualized assessment.

Keywords:
Coronary artery diseaseCoronary vessel anomaliesEchocardiographytransesophageal

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