Anomalous Aortic Origin of a Coronary Artery With an Interarterial Course

Stephens, Paul; Gaynor, J. William; Lorber, Richard; Vricella, Luca A.; Paridon, Stephen M.

doi:10.1016/j.jacc.2008.01.052

Cited by 70 publications

(30 citation statements)

References 19 publications

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“…Similar to Brothers et al [8], the current report also demonstrates a rare familial clustering of ARCA. To our knowledge, this is the first report of this phenomenon occurring in two asymptomatic adult siblings in whom the coronary anomaly was almost identical and confirmed by CCTA.…”

Section: O M / L O C a T E / I J C A Rdsupporting

confidence: 91%

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A tale of two coronaries

Rajani¹,

Friedman²,

Cheng³

et al. 2011

International Journal of Cardiology

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Section: O M / L O C a T E / I J C A Rdsupporting

confidence: 91%

“…More recently, Brothers et al [8] reported five families in which a child was diagnosed as having AAOCA and another family member was subsequently identified as coronary anomaly through screening with echocardiography. Of these five families, 3 had almost identical anomalies of the right coronary artery.…”

Section: O M / L O C a T E / I J C A Rdmentioning

confidence: 99%

A tale of two coronaries

Rajani¹,

Friedman²,

Cheng³

et al. 2011

International Journal of Cardiology

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“…The article in this issue of the Journal by Brothers et al (1) is the first study to show convincingly that the anomalous aortic origin of a coronary artery, that is, the left main coronary artery arising from the right sinus of Valsalva (ALCA) or the right coronary artery arising from the left sinus of Valsalva (ARCA), is familial. It is no surprise that coronary anomalies are familial.…”

mentioning

confidence: 99%

Finding Asymptomatic People With a Coronary Artery Arising From the Wrong Sinus of Valsalva

Cheitlin¹

2008

Journal of the American College of Cardiology

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“…It has recently been suggested that family screening of patients with an interarterial anomalous coronary artery is warranted as there may be a possible genetic element to this condition. 4 In this case, as the aberrant RCA coursed anteriorly to the pulmonary artery, no further intervention was required.…”

Section: Discussionmentioning

confidence: 88%

Emergency Percutaneous Coronary Intervention in the Setting of a Single Left Coronary Ostium

Williams

Bury

Brack

2009

Circ: Cardiovascular Interventions

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A 34-year-old man with no significant cardiac risk factors presented with an anterolateral ST-elevation myocardial infarction and was transferred to our institution for rescue percutaneous coronary intervention after failed thrombolysis. At the time of the procedure, he had ongoing chest pain, and there was persistent ST-segment elevation on the ECG. The right coronary artery (RCA) could not be located with a series of diagnostic catheters. Diagnostic images of the left coronary artery showed the circumflex artery and an aberrant dominant RCA arising from the left main stem but, despite multiple views, the left anterior descending artery could not initially be identified ( Figure 1; Videos 1 and 2). An aortogram demonstrated only a single coronary ostium in the left coronary sinus. After re-engaging the left coronary artery for further diagnostic images, the left anterior descending artery was finally identified, which was occluded at its ostium and visible in one view only (Figure 2; video 3). After guide wire passage, flow was restored in the culprit vessel and subsequent intervention was uncomplicated with a single 3-mm bare metal stent deployed (Figure 3; Videos 4 through 6). There was TIMI 3 flow at the end of the procedure, and the patient was discharged home 2 days later.Multislice cardiac computed tomography performed as an outpatient identified the aberrant RCA running anteriorly to the pulmonary artery and aorta (Figure 4). The left anterior descending artery stent was widely patent but there was poor run-off distal to the stented segment as a result of significant myocardial necrosis in the infarct territory. The patient was well and asymptomatic at 6-month follow-up. DiscussionAlthough congenitally aberrant coronary arteries are found in Ϸ1% to 2% of patients undergoing angiography, 1 a single coronary ostium is rare, occurring with an incidence of Ϸ0.05%. 2 Usually, a single ostium is located in the right coronary sinus; a single left coronary ostium is extremely rare and, when present, the aberrant RCA usually arises as an extension of the circumflex artery in the atrioventricular groove. The variant in this case, where the left main stem trifurcates into the three main coronary arteries, is exceedingly rare and only a few cases have been described in the literature. This is the first reported case of emergency percutaneous coronary intervention on a patient with a single left coronary ostium.

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Anomalous Aortic Origin of a Coronary Artery With an Interarterial Course

Cited by 70 publications

References 19 publications

A tale of two coronaries

A tale of two coronaries

Finding Asymptomatic People With a Coronary Artery Arising From the Wrong Sinus of Valsalva

Emergency Percutaneous Coronary Intervention in the Setting of a Single Left Coronary Ostium

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