Unicorn: Anomalous Double Ostium Left Main Coronary Artery With Intra-Mural Connection - Diagnosed with
David Horne1, Hina Mohsin2, Robert P Chen3
1Division of Cardiac Surgery, IWK Health Centre3688, Dalhousie University, Halifax, Canada.
World Journal for Pediatric & Congenital Heart Surgery
|January 4, 2022
Insights
A rare coronary artery anomaly, known as a unicorn vessel, was identified with a double ostium and common intramural connection. Advanced imaging techniques confirmed the diagnosis, preventing the need for cardiac surgery.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Anatomical Variations
Background:
- Congenital coronary artery anomalies are rare but can lead to significant cardiovascular events.
- The 'unicorn vessel' is an uncommon anomaly characterized by a single coronary artery ostium supplying both the left main and right coronary arteries.
- Accurate diagnosis is crucial for appropriate management and risk stratification.
Observation:
- A case report detailing a patient with an anomalous double ostium of the left main coronary artery.
- The anomaly featured a common intramural connection, a variation of the unicorn vessel anatomy.
- Detailed visualization was achieved using three-dimensional virtual endo-luminal angioscopy.
Findings:
- Three-dimensional virtual endo-luminal angioscopy provided precise anatomical detail of the anomalous coronary artery origin.
- Catheter-based imaging modalities corroborated the findings from angioscopy.
- The diagnosis was confirmed without the need for invasive surgical exploration.
Implications:
- This case highlights the utility of advanced non-invasive imaging in diagnosing complex coronary anomalies.
- Accurate anatomical characterization can guide clinical decision-making and potentially avoid unnecessary interventions.
- Understanding such rare variations is important for cardiovascular surgeons and interventional cardiologists.
Abstract:
Case report of a unicorn: anomalous double ostium left main coronary artery with common intra-mural connection. Three-dimensional virtual endo-luminal angioscopy and catheter-based imaging confirmed the diagnosis, subsequently avoiding cardiac surgical intervention.
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