Background: A single coronary artery (SCA) is a rare anomaly encountered using conventional coronary angiography. A right coronary artery (RCA) originating from a left anterior descending artery (LAD) is a rare subtype of SCA. Only a few cases are described in published literature.
Case presentation: We described this anomaly in a 55-year-old male who presented with angina pectoris. The anomalous RCA was suspected by conventional coronary angiogram and was confirmed by computed tomography (CT) coronary angiography. Using CT, we demonstrated the course of the abnormal vessel and its relation to the main vessel. We also detected the presence of plaque, which caused luminal stenosis of the proximal LAD, which may cause global ischaemia.
Conclusion: We concluded that although conventional coronary angiography is an important diagnostic method, new non-invasive methods such as CT coronary angiography can be a better screening tool to detect and characterise coronary anomalies.
Electronic Supplementary Materials
Supplementary Material 1: Coronary angiogram demonstrates anomalous RCA originating from LAD.
Supplementary Material 2: CTA coronary shows anomalous RCA originates from the mid-portion of LAD.
Central venous catheter insertion is a commonly performed procedure. This catheter is used to administer drugs and fluid, especially in critically ill patients, and monitor central venous pressure. We present a case of a retained guidewire for 17 months which was found incidentally from the abdominal and chest radiograph. We retrieved the retained J-tip guidewire using four loops retrieval snare. The retrieval process was complicated with the rupture of the guidewire, causing the unwinding of its outer sphere, leaving the inner monofilament dangling in the heart chamber. In this case report, we would like to describe the initial retrieval technique, which was failed and its bailout procedure.
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