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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Single coronary artery complicated with type A aortic dissection: a case report
Yuji Naito1, Fumitaka Suzuki2, Tatsuya Murakami2
1Department of Thoracic Surgery, Asahikawa City Hospital, 1-65, Kinsei-cho, Asahikawa, Hokkaido, 070-8610, Japan. ynaito2004@yahoo.co.jp.
Insights
This case report details a rare instance of type A aortic dissection in a patient with a single coronary artery anomaly. The condition required aortic arch replacement surgery following aortic re-dissection.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Congenital coronary artery anomalies are uncommon cardiovascular conditions.
- Aortic dissection, particularly type A, is a life-threatening emergency.
- The co-occurrence of these two conditions is exceptionally rare.
Purpose of the Study:
- To report a unique case of type A aortic dissection in a patient with a single coronary artery.
- To highlight the diagnostic and management challenges associated with this rare combination.
- To contribute to the limited existing literature on single coronary artery anomalies and aortic dissection.
Main Methods:
- Case presentation of a 77-year-old female with sudden onset back pain.
- Diagnosis of type A acute aortic dissection confirmed via imaging.
- Incidental finding of a single coronary artery anomaly on computed tomography (CT).
- Surgical intervention for aortic arch replacement due to re-dissection.
Main Results:
- The patient presented with type A aortic dissection and was initially managed conservatively.
- Computed tomography revealed an anomalous single coronary artery originating from the left sinus of Valsalva.
- The patient underwent successful aortic arch replacement surgery for re-dissection.
- Postoperative recovery was uneventful with discharge after 14 days.
Conclusions:
- This case underscores the importance of recognizing rare congenital anomalies in patients with aortic emergencies.
- Management of aortic dissection in the presence of coronary anomalies requires careful consideration.
- Further research into the relationship between coronary artery variations and aortic pathologies is warranted.
Abstract:
Congenital coronary artery anomalies complicated with aortic dissection are rare. We experienced a patient with a single coronary artery presenting with a type A dissecting aortic aneurysm. A 77-year-old woman who experienced sudden back pain and was diagnosed with type A acute aortic dissection was initially treated conservatively because the false lumen thrombosed entirely. Computed tomography taken during 5 weeks of hospitalization incidentally revealed an anomalous single coronary artery arising from the left sinus of Valsalva, and the right coronary artery orifice was absent. One month after being transferred to another institution for rehabilitation, she was reintroduced to us for re-dissection of the aorta. An urgent operation involving aortic arch replacement was performed. There was a solitary coronary artery orifice at the left sinus of Valsalva and no ostium at the right sinus. The postoperative course was uneventful, and the patient was discharged 14 days after the surgery. Only 3 cases involving a single coronary artery complicated with dissecting aortic aneurysm have been reported previously.
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