Abstract
Anatomical variations whereby all three coronary arteries arise from a solitary coronary ostium are very rare. A 61-year-old female underwent coronary angiography for assessment of severe biventricular systolic dysfunction. This demonstrated the entire coronary circulation, comprising of all 3 major epicardial arteries, arising from a solitary coronary ostium located in the right coronary cusp. Selective cannulation of all 3 arteries was achieved with the 5F internal mammary catheter. The LAD had an initial posterior course, likely between the aorta and pulmonary artery, and was dual supplied by the RCA, which was large and dominant. An aortogram confirmed no other coronary arteries arising from the remaining aortic cusps. A CT coronary angiogram was scheduled, however the patient unfortunately died from a sudden asystolic arrest. To our knowledge, this is the first reported case of anomalous coronary circulation arising from a solitary coronary ostium in Australia.Figure 1RCA, 2 – LAD, 3 – LCxView Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 1RCA, 2 – LAD, 3 – LCxView Large Image Figure ViewerDownload Hi-res image Download (PPT)
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