Percutaneous Coronary Intervention for the Anomalous Left Coronary Artery Originating from the Noncoronary Cusp.

Toshiki Kuno,Yohei Numasawa,Toshiyuki Takahsashi

doi:10.1155/2016/2097174

Toshiki Kuno, Yohei Numasawa + Show 1 more

Open Access

https://doi.org/10.1155/2016/2097174

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Abstract

Percutaneous coronary intervention (PCI) for anomalous left coronary artery (LCA) originating from the noncoronary cusp (NCC) is challenging, as it poses difficulties with the engagement of the guiding catheter and the establishment of backup support. This report examines the case of a 69-year-old woman with unstable angina of anomalous LCA origin. The computed tomography showed a diffuse plaque in the middle of the left anterior descending (LAD) artery and an anomalous LCA originating from the NCC. After successful engagement of a straightened Judkins-Left diagnostic catheter, the angiography revealed a diffuse plaque in the middle of the LAD artery. We then engaged a Judkins-Right guiding catheter. Due to the weak backup support of the guiding catheter, we used another wire to stabilize it, and the stent was then implanted successfully. To our knowledge, this is the first case report of PCI for an anomalous LCA originating from the NCC.

Highlights

The anomalous origin of the left coronary artery (LCA) from the noncoronary cusp (NCC) is a rare congenital anomaly found in 0.008%–0.012% of coronary angiography cases [1, 2]
Due to the difficulty in correctly engaging the guiding catheter and in gaining backup support, the performance of percutaneous coronary intervention (PCI) for an anomalous LCA originating from the NCC is challenging
We report a case of unstable angina of anomalous LCA origin in which the patient underwent a successful PCI

Summary

Introduction

The anomalous origin of the left coronary artery (LCA) from the noncoronary cusp (NCC) is a rare congenital anomaly found in 0.008%–0.012% of coronary angiography cases [1, 2]. There have been few reports of percutaneous coronary intervention (PCI) for anomalous LCAs originating from the NCC. Due to the difficulty in correctly engaging the guiding catheter and in gaining backup support, the performance of PCI for an anomalous LCA originating from the NCC is challenging.

Case Presentation

Discussion