Case report: a common trunk of the coronary arteries

Erich Brenner,Romed Hörmann,Elisabeth Pechriggl,Bernhard Moriggl,Marit Zwierzina

doi:10.1007/s00276-016-1736-4

Erich Brenner, Romed Hörmann + Show 3 more

Open Access

https://doi.org/10.1007/s00276-016-1736-4

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Abstract

We describe the heart from a 79-year-old woman with no medical history of cardiac complaints. Her heart shows a regular right coronary artery (RCA) and a variant left coronary artery (LCA) arising from the right sinus of Valsalva. The common stem of the RCA and the LCA is extremely short. The LCA depicts a preinfundibular course with a cranial-anterior loop and reaches the intersection of the anterior interventricular sulcus and the left coronary sulcus, where it divides into the regular branches, the anterior interventricular branch (left anterior descending, LAD) and the circumflex branch (left circumflex, LCx). All further branching resembles a normal distribution with the posterior interventricular branch coming for the RCA. Such a variant LCA is extremely rare with a reported incidence of 0.17 %. However, recognition and angiographic demonstration of such a variation assume the highest priority in a patient undergoing, for instance, direct coronary artery surgery or prosthetic valve replacement.

Highlights

Among the variations of the coronary arteries, the presence of a common trunk of the coronary arteries is well known [1, 11, 27]
The left coronary artery (LCA) depicts a preinfundibular course with a cranial-anterior loop and reaches the intersection of the anterior interventricular sulcus and the left coronary sulcus, where it divides into the regular branches, the anterior interventricular branch and the circumflex branch
All further branching resembles a normal distribution with the posterior interventricular branch coming for the right coronary artery (RCA)

Summary

Introduction

Among the variations of the coronary arteries, the presence of a common trunk of the coronary arteries is well known [1, 11, 27]. Variations and anomalies of the coronary arteries are of clinical interest as unrecognized coronary variations and anomalies may lead to errors in diagnoses, and surgical problems may follow if a variant or anomalous coronary artery is excluded from perfusion during open heart surgery, or if it is unwittingly incised by the surgeon [27]

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