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[A case of coronary artery bypass grafting for single coronary artery complicated by angina pectoris]
S Makino1, K Saito, T Kinoshita
1Department of Thoracic and Cardiovascular Surgery, Anjo Kosei Hospital, Japan.
Insights
A rare single coronary artery anomaly causing angina pectoris was successfully treated with coronary artery bypass grafting (CABG). The surgery relieved the patient's symptoms, demonstrating CABG
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Anatomical Variations
Background:
- Single coronary artery is a rare congenital anomaly.
- Coronary artery anomalies can lead to myocardial ischemia and angina pectoris.
- This case presents a unique anatomical variation of a single coronary artery.
Observation:
- A 74-year-old male presented with angina pectoris.
- The patient had a single coronary artery originating from the left coronary sinus, bifurcating into LAD and CX.
- An abnormal communicating branch from the LAD mimicked the RCA, with distal RCA and PDA arising from CX.
Findings:
- Significant stenosis (75%) was found in the LAD and (90%) in the CX.
- Coronary artery bypass grafting (CABG) was performed using two saphenous vein grafts.
- The grafts were anastomosed to LAD and distal CX.
Implications:
- Successful CABG in this complex single coronary artery anomaly led to complete symptom resolution.
- This case highlights the importance of accurate diagnosis and tailored surgical approaches for rare coronary artery variations.
- Effective management of angina pectoris in patients with single coronary artery anomalies is achievable with surgical intervention.
Abstract:
A case of coronary artery bypass grafting (CABG) for single coronary artery complicated by angina pectoris (AP) was reported. The patient was a 74-year-old male, complained of anginal discomforts. His single coronary artery originated in left coronary sinus, bifurcated to the left anterior descending artery (LAD) and the circumflex artery (CX), and then, an abnormal communicating branch, passing in front of the right ventricular outflow, was branched from the proximal region of LAD; it showed a route corresponding to the proximal region of the right coronary artery (RCA). The distal region of RCA and the posterior descending artery were angiographed in continuity from CX. Other findings included 75%-stenosis at LAD-#6 and 90%-stenosis at CX-#13. Using two saphenous vein grafts, CABG operation was carried out on those regions at LAD-#7 and distal CX corresponding to #3 normally. Postoperatively, anginal discomforts disappeared, and favorable results were obtained.