Single coronary artery (SCA) is defined as only one coronary artery arising from one aortic sinus of Valsalva that supplies the entire myocardium. SCA anomaly is very rare, noted in 0.04% (56 of 126 595) of diagnostic angiography and 3% (56 of 1686) of coronary anomalies. 1 Coronary artery anomalies are usually diagnosed incidentally during coronary angiography and at post-mortem evaluation. The prevalence of coronary artery anomalies was reported to be 1.3% (1686 of 126 595) of diagnostic coronary angiograms. 1 The most common coronary artery anomaly seen is the separate origin of the left anterior descending (LAD) and left circumflex (LCX) artery followed by an origin of LCX artery from right coronary artery (RCA) with a retro-aortic course, and origin of right or left coronary artery from the opposite sinus. 1 The classification of SCA anomaly has been proposed by several authors. 2-4 It was first described by Ogden et al, 3 in 1970 and later modified by Lipton et al, 4 in 1979. It was last modified by Yamanaka et al 1 by adding "S" septal, "C" combined Type of courses. The modified classification is shown in Figure 1A-C.

No abstract

A rare case of subvalvular aneurysm diagnosed by two-dimensional echocardiography and confirmed at cardiac catheterization is presented.

Background Dual antiplatelet therapy is the current standard of care after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). We intended to study the pattern of use of ticagrelor in patients with acute coronary syndrome undergoing PCI and the effect of switching over to other P2Y12 receptor inhibition on clinical outcomes. Results All patients aged > 18 years who had been admitted with acute coronary syndrome and had been provided ticagrelor as the second antiplatelet agent were included as study participants. The primary outcome of the study was the composite outcome of death, recurrent myocardial infarctions, re-intervention, and major bleeding. We studied 321 patients (54 female patients, 16.82%). The mean age of the patients was 56.65 ± 11.01 years. Ticagrelor was stopped in 76.7% on follow-up. It was stopped in 6.3%, 13.5%, 13.1%, 21.9%, and 45.1% of patients during the first month but after discharge, between first and third months, between 3 and 6 months, between 6 and 12 months, and after 12 months, respectively. In the majority of patients, ticagrelor was replaced by clopidogrel (97.9%). It was stopped according to the physician’s discretion in 79.3% of patients, whereas it was the cost of the drug that made the patient to get swapped to another agent in 18.6%. No difference in the primary composite outcome was observed between the groups where ticagrelor was continued post 12 months and ticagrelor was continued and ticagrelor was switched-over to another agent. Similarly, no difference in death, recurrent myocardial infarctions, re-interventions, or major bleeding manifestations was observed between the two groups. Conclusion In patients with acute coronary syndrome who undergo PCI, we observed that early discontinuation of ticagrelor and switching over to other P2Y12 inhibitors after discharge did not affect clinical outcomes.