Single Right Coronary Artery: Clinical and Angiographic Findings with Surgical Management

Kafrouni, George; Khan, A. Hafeez; sen, James L. Wolf

doi:10.1016/s0003-4975(10)61379-3

Cited by 14 publications

(3 citation statements)

References 15 publications

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“…For patients who develop end-stage heart failure from ischaemic cardiomyopathy, heart transplantation can be considered. Although there are documented cases of coronary artery bypass graft (CABG) surgery in single vessel hypoplasia [9] , this is not commonplace. Moreover, CABG may not be feasible when there is diffuse disease [5] .…”

Section: Discussionmentioning

confidence: 99%

Hypoplastic Coronary Artery Disease Presenting With Ventricular Fibrillation Cardiac Arrest

Guo¹,

Bakhshi²,

Hara³

et al. 2021

Journal of the American College of Cardiology

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Section: Discussionmentioning

confidence: 99%

Hypoplastic Coronary Artery Disease Presenting With Ventricular Fibrillation Cardiac Arrest

Guo¹,

Bakhshi²,

Hara³

et al. 2021

Journal of the American College of Cardiology

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“…Surgical treatment for coronary artery hypoperfusion due to a single coronary artery and atresia or stenosis of the coronary ostium has been reported [ 6 , 8 ]. In our case, surgery was found impossible due to the entire left coronary system hypoplasia.…”

Section: Discussionmentioning

confidence: 99%

Left Main Coronary Artery Hypoplasia in Elderly

Tiryakioğlu

Özkan

Bahadir

et al. 2016

Case Reports in Cardiology

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Congenital anomalies of the coronary artery causing coronary occlusive disease may be of many different types. A 67-year-old woman with no coronary risk factors was referred for coronary angiography with few months' history of angina. The patient underwent coronary angiography due to ischemic cardiac symptoms with nondiagnostic exercising test. In coronary angiography, the left main coronary artery was arising from normal anatomical position; however, left anterior descending artery and circumflex artery were hypoplastic. The treatment of patient was discussed in cardiology-cardiovascular surgery council and coronary surgery was found inappropriate due to the hypoplasia of the left coronary system entirely.

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“…The compression between great vessels was thought of as a possible reason initially, however this hypothesis was later contested because hydrostatic pressure in pulmonary artery is much lower than coronary perfusion pressure during exercise. Hence, the 'Kinking' of the left main coronary artery at its origin from the RCA by an increased angulation caused by the distension of the aorta during exercise was proposed as the pathogenic mechanism [4].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Coronary Intervention of Hidden Coronary Artery-Unusual Type of Isolated Single Coronary Artery

Patil

Rachaiah

Ramalingam

et al. 2016

JCDR

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A 55-year-old woman presented to the Emergency Department with typical angina of 4 hours duration. Patient was diagnosed as having acute coronary syndrome-acute Inferoposterior wall myocardial infarction. Patient had past history of hypertension, diabetes mellitus, dyslipidemia and hypothyroidism for last five years for which she was on following medication: Telmisartan 40mg once daily, glimepride 1mg once daily, thyroxin 25mg once daily. Patient had no family history of coronary artery disease.Initial physical examination revealed, heart rate of 62 beats per minute, blood pressure of 110/70mmHg, and was otherwise unremarkable. An Electrocardiogram (ECG) revealed a normal sinus rhythm with Inferoposterior wall myocardial infarction. A two dimensional echocardiogram revealed LV segmental hypokinesia and an ejection fraction of 40%. Patient was immediately treated with thrombolytic therapy. As patient had failed thrombolysis by persistent angina and unresolved ST segment by ECG, hence, rescue PCI was considered. Coronary angiography was performed which revealed LCx total occlusion and RCA could not be cannulated [Table/ Fig-1,2]. Hence, anomalous origin was suspected and proceeded with PTCA to LCx, pending Computed Tomography Coronary Angiogram (CT CAG) to identify origin of RCA. During PTCA when LCx was predilated, interestingly it was noted that RCA was arising from distal LCx (single coronary artery was noted). Right coronary artery also had 90% stenosis at the site of origin from distal LCx (RCA was hidden within occluded LCx which also had critical lesion). After predilatation of LCx, Keywords: Biventricular dysfunction, Inferior wall myocardial Infarction, Left circumflex artery ABSTRACTSingle coronary artery is a rare congenital coronary artery anomaly, the incidence of which is 0.024-0.066% as described in literature. Report of cases having single coronary artery along with acute myocardial infarction are scanty and reports of percutaneous intervention in such a situation are even fewer, technically challenging and potentially cataclysmic. As single coronary artery supplies the entire myocardium, occlusion of this can result in significant ischemic insult, resulting in severe biventricular dysfunction. Percutaneous Coronary Intervention (PCI) of single coronary artery is technically challenging and carries high risk which may be equated to left main intervention. We report a rare interesting case of L1 variety of single coronary artery which presented as acute inferoposterior myocardial infarction with successful rescue PCI to Left Circumflex Artery (LCx).

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Single Right Coronary Artery: Clinical and Angiographic Findings with Surgical Management

Cited by 14 publications

References 15 publications

Hypoplastic Coronary Artery Disease Presenting With Ventricular Fibrillation Cardiac Arrest

Hypoplastic Coronary Artery Disease Presenting With Ventricular Fibrillation Cardiac Arrest

Left Main Coronary Artery Hypoplasia in Elderly

Percutaneous Coronary Intervention of Hidden Coronary Artery-Unusual Type of Isolated Single Coronary Artery

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