Single coronary artery and coronary artery-pulmonary artery fistula in a variation of the Shone complex

Kartal, Yigit Can; Tekin, Ali Fuat; Baş, Serap; Ozturk, Erkut

doi:10.1007/s00247-023-05731-5

Cited by 1 publication

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“…[4] Increasing studies have found that 15% to 45.5% of patients with SCA malformation without atherosclerosis develop angina symptoms, and the patients with SCA without associated atherosclerotic coronary artery disease were managed conservatively with medications and yielded good outcomes. [15][16][17] Rigatelli et al classified coronary anomalies into 4 categories based on clinical risk, including class A (benign), class B (associated with fixed myocardial ischemia), class C (severe, with the potential to lead to sudden cardiac death), and class D (needing urgent management due to deterioration of the clinical situation). [18] This case belonged to category D, and was treated with thrombus aspiration and thrombolytic therapy under the support of IABP.…”

Section: Discussionmentioning

confidence: 99%

Successful percutaneous coronary intervention in a congenital single right coronary artery with acute myocardial infarction: A case report and literature review

Li,

Lv,

Han

et al. 2024

Medicine

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Rationale: Single coronary artery (SCA) is a rare coronary artery malformation. SCA combined with atherosclerotic plaques can cause severe and widespread myocardial ischemia and infarction, leading to hemodynamic instability and even sudden death. Patient concerns: A 48-year-old Chinese man was admitted for treatment of persistent chest tightness and panic for 5 hours. The patient was a lorry driver with high work intensity and mental stress, with body mass index of 33.78, history of smoking and alcohol consumption, but no history of hypertension and diabetes. Diagnoses: Admission examination showed Troponin was 183.083 µg/L and CK-MB value was >300 µg/L. The patient was diagnosed with a congenital single right coronary artery (RCA) with acute myocardial infarction (AMI) by coronary angiography (CAG). Due to atherosclerotic plaques rupture, a complete occlusion of the proximal RCA with thrombolysis in myocardial infarction grade 0 of distal blood flow were found. Interventions and outcomes: The patient was treated with thrombus aspiration and thrombolytic therapy by percutaneous coronary intervention under the support of intra-aortic balloon pump. Postoperative the chest tightness and panic were relieved, and CAG revealed that the proximal thrombus of the RCA was reduced, and distal blood flow was restored to thrombolysis in myocardial infarction grade 3. After 2 weeks of intensive antithrombotic and lipid-regulating drug therapy, the patient was successfully discharged. Follow-up for 6 months, the patient was able to live and work normally without experiencing chest tightness and chest pain. Computed tomography angiography (CTA) confirmed a congenital single RCA with patent lumen and no severe stenosis. Lessons: The congenital single RCA is very rare, and it is fatal in conjunction with acute coronary syndrome. Early detection and appropriate treatment is critical for AMI patient with single RCA. CAG is the gold standard for diagnosis of single RCA, and CTA is a necessary to describe the anatomical course of abnormal coronary arteries.

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