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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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Successful Management of Anomalous Lipton R-III Right Coronary Artery Chronic Total Occlusion

Ankit Gupta1, Sreenivas Reddy2, Ashish Jain1

  • 1Department of Cardiology, All India Institute of Medical Sciences, Raebareli, Raebareli, IND.

Cureus
|June 3, 2024
PubMed

Insights

Successful percutaneous coronary intervention (PCI) managed a challenging case of chronic total occlusion (CTO) in a patient with a rare congenital coronary artery anomaly. This case highlights effective treatment strategies for complex coronary artery disease.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Coronary Artery Disease

Background:

  • Chronic total occlusion (CTO) presents significant technical challenges during percutaneous coronary intervention (PCI).
  • Congenital coronary artery anomalies complicate PCI, particularly when associated with CTO lesions.

Observation:

  • A 64-year-old male with hypertension and chronic smoking presented with Canadian Cardiovascular Society II angina.
  • Coronary angiography identified a proximal right coronary artery CTO.
  • The patient had an anomalous origin of coronary arteries from a single right sinus, classified as Lipton R-III.

Findings:

  • Successful PCI was performed for the complex CTO lesion.
  • The management strategy effectively addressed the CTO in the context of the coronary anomaly.

Implications:

  • This case demonstrates the feasibility of PCI for CTO in the presence of complex coronary anomalies.
  • Successful intervention can improve outcomes for patients with challenging coronary artery anatomy and disease.

Keywords:
angiographyanomalous coronary arterychronic total occlusioncoronary artery anomalypercutaneous coronary interventionsingle ostiumsingle sinus

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