Abstract
Coronary anomalies are rare congenital abnormalities and are often associated with complex congenital heart diseases and manifest in infancy or childhood. Single coronary artery arising from the sinus of Valsalva supplying the entire heart is one of these congenital anomalies. The prevalence is reported to be approximately 0.3 to 2.0% of the general population, mostly clinically asymptomatic and with good prognosis. However, in some cases this anomaly can present as acute coronary syndrome in adults. Literature reports of patients with both a single coronary artery and an acute coronary syndrome are sparse, and percutaneous coronary interventions in such cases are technically challenging. We report a case of a patient with a single coronary artery suffering from an acute coronary syndrom who underwent complex bifurcational percutaneous intervention and provide a review of the literature.
Highlights
Coronary anomalies are rare congenital abnormalities and are often associated with complex congenital heart diseases and manifest in infancy or childhood
The coronary anomaly was assumed to be a benign type of single coronary artery (SCA) because no evidence of proximal right coronary artery compression driven by an interarterial course between the pulmonary artery and the aorta was found
The inter-arterial course is the most malignant that is strongly associated with sudden death, myocardial ischemia or congestive heart failure being caused by a compression of the origin of the right coronary artery between the pulmonary trunk and the aorta
Summary
Coronary anomalies are rare congenital abnormalities and are often associated with complex congenital heart diseases and manifest in infancy or childhood. Coronary angiography revealed a single coronary artery (SCA) originating from the left coronary sinus with significant stenoses of the circumflex artery as well as the right coronary artery (Figure 1a and 1b). The coronary anomaly was assumed to be a benign type of SCA because no evidence of proximal right coronary artery compression driven by an interarterial course between the pulmonary artery and the aorta was found.
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