Common origin of all three coronary arteries from the right sinus of Valsalva – first case study accompanied by mitral valve prolapse and vein anomaly, second case study followed by successful percutaneous coronary intervention of right coronary artery stenosis

Abstract

Congenital anomalies of the coronary arteries can be divided into two broad categories: those that alter myocardial perfusion and those that do not. In coronary anomalies not altering myocardial perfusion, the coronary arteries originate from the aorta, but their origins are in unusual positions. Although myocardial perfusion is normal, the angiographer may have trouble locating them. Patients with an anomalous left main coronary artery arising from the right sinus of Valsalva are presented. The diagnosis was made by coronary angiography, transesophageal echocardiography and multislice computed tomography (MSCT). We present two cases: the first patient with coronary abnormalities had accompanying venous anomaly of lower extremities and mitral valve prolapse as well. The second patient had a history of anterior wall myocardial infarction and angioplasty with stent implantation. The extraordinary passage of the left coronary artery between the pulmonary trunk and sternum, undetectable in coronarography, was discovered due to MSCT.

A Cadaveric Case Report of a Double Right Coronary Artery and Its Clinical Implications

“…The selection of an appropriate guiding catheter and preoperative imaging of the coronary arterial distribution could be significant. Catheter selection was important in some cases, especially if an anomalous RCA was involved in acute myocardial infarction (MI), as stenosis might have occurred in the proximal regions closer to its origin from the aorta [ 17 , 18 ]. In a study involving 185 patients with acute MI and atherosclerosis, eight patients had anomalous origin and occlusion at the proximal portion of the RCAs [ 19 ].…”