Simple Provisional Stenting or two-stent Strategies to Treat Anomalous Right Coronary Originating from the mid of left Anterior Descending Coronary Artery

Xuguang Qin

doi:10.31579/2641-0419/099

Abstract

Congenital anomalies of coronary arteries (CAAS) are very rare and usually documented as an incidental finding during routine catheter or CT angiograms performed for other reasons. Their prevalence ranges from 0.2% to 1.3% based published series. The most common coronary artery anomaly is origination of the left circumflex coronary (LCX) artery from the proximal of right coronary artery (RCA) or right sinus of Valsalva. The second is separate origination of the left anterior descending coronary artery (LAD) and LCX artery from the left sinus of Valsalva. Herein, we present three cases that the anomalous RCA arises from the mid of left anterior descending coronary artery (LAD). The bifurcation lesions of first case was treated using two-stent strategies of DK culotte, excellent angiography results was observed. The last two cases were treated using simple provisional stenting strategy: one stent was deployed crossover the ostium of the anomalous coronary artery, final angiographic results were excellent. These cases are extremely rare. We bring forth them in an attempt to highlight their significance, and make cardiologist to understand what important the anomalies are, and the strategy how to treatment these bifurcation lesions.

Highlights

Congenital anomalies of coronary arteries (CAAS) are very rare and usually documented as an incidental finding during routine catheter or CT angiography performed for other reasons
When the anomalous right coronary originates from the mid of left anterior descending coronary artery, it is called single coronary artery (SCA) [2], its prevalence is less than 0.024% [3]
The anomalous coronary artery is first designated with "R" or "L" depending upon whether the ostium is located in the right or left sinus of Valsalva

Summary

Introduction

Congenital anomalies of coronary arteries (CAAS) are very rare and usually documented as an incidental finding during routine catheter or CT angiograms performed for other reasons. We present three cases that the anomalous RCA arises from the mid of left nterior descending coronary artery (LAD). The last two cases were treated using simple provisional stenting strategy: one stent was deployed crossover the ostium of the anomalous coronary artery, final angiographic results were excellent. Artery (RCA) originating from the mid of LAD segment (Figure 1a, 1b).

Results

Conclusion