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Single coronary artery: a case report and review of current literature
1Department of Cardiology, Singapore General Hospital, Singapore.
Insights
A rare single coronary artery anomaly, where the right coronary artery originated proximally, was identified. This case details the first angioplasty performed on the left anterior descending artery within this unique anatomical variation.
Area of Science:
- Cardiology
- Anatomical Variations
- Interventional Cardiology
Background:
- Congenital coronary artery anomalies are rare but can predispose individuals to myocardial ischemia.
- A single coronary artery is an uncommon anomaly with varying origins and branching patterns.
Observation:
- A patient presenting with suspected coronary artery disease was found to have a single coronary artery originating from the left sinus of Valsalva.
- The anomalous vessel gave rise to the right coronary artery proximally and then branched into the left anterior descending, ramus intermedius, and left circumflex arteries distally.
Findings:
- The patient's anginal symptoms were linked to significant stenosis in the proximal left anterior descending artery.
- Successful percutaneous coronary angioplasty was performed on the stenosed left anterior descending artery.
Implications:
- This case represents the first documented instance of angioplasty on the left anterior descending artery within a single coronary artery anomaly.
- Understanding and managing such rare anatomical variations are crucial for effective interventional cardiology treatment.
Abstract:
We present a case of a single coronary artery where the right coronary artery (RCA) arose from its proximal part. This rare anomaly was detected during elective coronary angiography in a patient with suspected coronary artery disease. The single coronary artery originated from the left sinus of valsalva, giving rise to RCA proximally and distally dividing into left anterior descending (LAD), ramus intermedius and left circumflex (LCX) arteries. The anginal symptoms in this patient was attributed to a significant stenosis at the proximal LAD which was subsequently dilated by coronary angioplasty. To the best of our knowledge, this is the first reported case of angioplasty of LAD in an anomalous single coronary artery.