Widowmaker Right Coronary Artery Treated With Drug-Eluting Stent Implantation

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Congenital Heart Disease

Background:

• A single coronary artery system is a rare congenital anomaly.
• Anomalous coronary origins can lead to myocardial ischemia and infarction.
• Obstructive lesions in single coronary arteries pose unique management challenges.

Purpose of the Study:

• To report a case of a single coronary artery arising from the right sinus of Valsalva.
• To describe the management of an obstructive mid-vessel lesion in this anomaly.
• To evaluate the long-term outcome of percutaneous coronary intervention in such a case.

Main Methods:

• Diagnostic coronary angiography to delineate the anomalous coronary anatomy.
• Stress testing to assess for functional ischemia.
• Percutaneous coronary intervention with a first-generation drug-eluting stent.

Main Results:

• The patient had a single coronary artery originating from the right sinus of Valsalva with a mid-vessel obstructive lesion.
• Stress testing confirmed functional evidence of ischemia.
• Successful stenting with a Cypher drug-eluting stent was performed.
• The patient remained asymptomatic at 14-year follow-up.

Conclusions:

• A single coronary artery system from the right sinus of Valsalva can be successfully managed with percutaneous coronary intervention.
• Drug-eluting stents provide durable long-term results in treating obstructive lesions in anomalous coronary arteries.
• This case highlights the importance of comprehensive assessment and tailored treatment for rare coronary anomalies.