Incidental single coronary artery in an octogenarian with acute type A aortic dissection

Abstract

Single coronary artery (SCA) in the absence of other major congenital cardiovascular anomalies is rare. We report an extremely rare case of acute aortic dissection in an octogenarian who had a single left coronary artery with the right coronary artery originating from the distal circumflex. A single ostium was incidentally detected by visual inspection during an operation. We diagnosed the anomaly in detail by postoperative 64-slice multi-detector computed tomography. As we performed an emergency operation, it was difficult to recognize SCA preoperatively. In this situation, it is very important to establish adequate myocardial protection and careful dissection is necessary to avoid iatrogenic injury.

Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

“…Twenty-six cases of congenital absence of the RCA have been reported in 24 articles in the last decade ( Table 1 ). 8 – 31 The mean age of patients at the time of diagnosis of congenital absence of the RCA was 53 years. Of the 26 reported cases, 14 patients were women, and 5 of them presented with acute myocardial infarction.…”

“… 33 A combination of these imaging modalities yields a more robust assessment of the coronary arteries and their neighboring structures. 10 These techniques also better reflect the anatomical course of the vessels and the course of the transverse trunk than other modalities. Therefore, MDCT and CTA might also be helpful in diagnosing congenital absence of the RCA.…”

“…Of the 26 previously reported cases, 16 had an L-I pattern. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Therefore, the L-I pattern may be more likely to occur than the L-II pattern. Individuals with congenital absence of the RCA present with non-specific clinical features and ECG manifestations.…”

Three different situations and approaches in the management for anomalous origin of the right coronary artery from the left coronary sinus: case report

“…Also, magnetic resonance angiography can be used to identify anomalous vessels [ 3 ]. However, when emergency surgery is required, it is difficult to perform multi-detector CT scanner or magnetic resonance angiography in all patients because of unstable hemodynamics and the time required for the scan [ 7 ]. In our cases, multi-detector CT scanner or magnetic resonance angiography could not be performed because of an emergency situation and unstable hemodynamics in patient 2 and because ARCA was incidentally diagnosed during surgery in patient 3.…”

Arteria coronaria única en paciente octogenario

“…El stent en CX permeable, con hiperplasia neointimal leve. La ACU, en ausencia de otra enfermedad congénita, no tiene implicancia pronóstica, y ha sido descrita en individuos de la octava década de la vida 3 , como el ejemplo que presentamos. La actitud terapéutica se debe individualizar en función de los síntomas, la presencia de lesiones coronarias asociadas y la edad del paciente 1 .…”