Anomalous Aortic Origin of Coronary Arteries from the Opposite Sinus: A Case Report

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Imaging

Background:

• Anomalous aortic origin of coronary arteries from the opposite sinus (AAOCA) is a rare congenital anomaly.
• Management strategies for AAOCA require careful consideration, especially when associated with obstructive coronary artery disease.
• Advanced imaging modalities are crucial for precise anatomical classification of AAOCA, distinguishing benign from potentially malignant variants.

Observation:

• A 64-year-old male incidentally found to have AAOCA.
• The left anterior descending artery originated from the right coronary cusp, anterior to the left circumflex artery and right coronary artery (RCA) ostia.
• The patient presented with obstructive disease in the RCA.

Findings:

• The specific anatomical course of the anomalous left anterior descending artery was identified.
• Percutaneous coronary intervention (PCI) was successfully performed for the obstructive RCA disease.
• The patient was managed conservatively for the AAOCA itself, with regular follow-up.

Implications:

• This case underscores the importance of recognizing AAOCA and its potential anatomical variations.
• It demonstrates a feasible management approach combining PCI for concurrent coronary artery disease with observation for the anomaly.
• Highlights the role of modern imaging in characterizing AAOCA and guiding clinical decision-making.