Stenting of anomalous left main coronary artery arising from the right sinus of Valsalva: A case report

Tejada, Julio García; Hernández, Felipe; Sánchez, Ignacio Gómez de Terreros; Martín‐Asenjo, Roberto

doi:10.1016/j.ijcard.2006.07.149

Cited by 15 publications

(10 citation statements)

References 7 publications

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“…The inter-arterial course of the LCA, between the aortic root and the pulmonary artery trunk, correlates with a higher incidence of angina, syncope and sudden death [5]. The anomalous origin of LCA from the right sinus of Valsalva is not always associated with symptoms of angina pectoris.…”

Section: Discussionmentioning

confidence: 97%

Right Coronary Artery Originating From the Left Coronary Sinus: A Rare Coronary Artery Anomaly

Conkbayır

2014

Russ J Cardiol

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Anomalous origin of the right coronary artery (RCA) from the left coronary sinus is a rare congenital anomaly. Here, we report a case of a 54-year-old symptomatic woman who was admitted with a history of unstable angina pectoris, hypertension, coronary arteriosclerosis, diabetes mellitus, hypercholesterolemia and previous coronary bypass operation (CABG). Coronary angiography was performed and a right coronary artery was discovered, which was seen to arise from the left coronary sinus. Аномальное отхождение правой коронарной артерии (RCA) из левого коро-нарного синуса -редкая врожденная аномалия. Здесь, мы сообщаем о слу-чае 54-летней женщины, которая была госпитализирована с нестабильной стенокардией, гипертонией, коронарным атеросклерозом, сахарным диабе-том, гиперхолестеринемией и предыдущими операциями аортокоронарного шунтирования (АКШ) в анамнезе. При коронарной ангиографии правой коро-нарной артерии был обнаружено, что она восходит из левого коронарного синуса. RussРоссийский кардиологический журнал 2014, 1 (105), Англ.: 56-57Ключевые слова: правая коронарнаяй аномалия, врожденный.

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Section: Discussionmentioning

confidence: 97%

Right Coronary Artery Originating From the Left Coronary Sinus: A Rare Coronary Artery Anomaly

Conkbayır

2014

Russ J Cardiol

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“…However, the anomaly is not always associated with angina pectoris; rather, the presence of angina pectoris varies in accordance with the relationship between the anomalous LMCA, the aorta, and the PA. An interarterial course of the LMCA-between the aortic root and the PA trunk-correlates with a higher incidence of angina, syncope, and sudden death. 3,5 Other anatomic variants for the course of the anomalous LMCA-including retro-aortic, right ventricular free-wall, and septal courses, and a course along the floor of the right ventricle-are considered benign. 3,6 In reviewing the medical literature, we found rare cases of anomalous origin of the LMCA from the right coronary cusp.…”

Section: Discussionmentioning

confidence: 99%

“…3,6 In reviewing the medical literature, we found rare cases of anomalous origin of the LMCA from the right coronary cusp. [3][4][5][6][7][8] Most reports concern the anomalous origin of the right coronary artery. To the best of our knowledge, no reported case is similar to ours in regard to clinical presentation and the presence of an unusually long intramural course of the LMCA between the aortic root and the PA trunk.…”

Section: Discussionmentioning

confidence: 99%

Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Chang¹,

Hsieh²,

Chao³

et al. 2015

Texas Heart Institute Journal

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C ongenital anomalies of coronary arteries are rare, insofar as they are seen upon coronary angiography at a rate of approximately 1%.1 Anomalous origin of the left main coronary artery (LMCA) with subsequent intramural coursing between the ascending aorta and the main pulmonary artery (PA) is certainly even rarer.2 In young people engaged in strenuous exercise, this condition commonly results in myocardial ischemia, ventricular arrhythmia, and sudden cardiac death. We report such a case in which the result was favorable. Case ReportIn March 2011, an 18-year-old woman suddenly lost consciousness and collapsed upon completion of a 10-km run at her university's annual campus marathon. She had not been trained for running in accordance with any protocol, and this was her first time to expend such a level of effort. She had not experienced any symptoms before the event.In our emergency department, a 15-to 20-min course of cardiopulmonary resuscitation and electrical shock for ventricular fibrillation (Fig. 1A) enabled a return of spontaneous circulation (ROSC), and the patient was admitted to our medical intensive care unit (MICU).In the MICU, she was unconscious and her systemic pressure remained low (~80/50 mmHg), despite a high intravenous dose of an inotropic agent. Her jugular venous pressure was elevated, and her body temperature was 36 °C. A 12-lead electrocardiogram (ECG) obtained 20 minutes after ROSC showed sinus tachycardia with nonspecific ST-T changes and no prolonged QTc interval (QTc, 446 ms) (Fig. 1B). Her initial arterial blood gas analysis showed hypoxia with respiratory and metabolic acidosis. The chest radiograph taken immediately after admission to the MICU showed a normal heart size with bilateral pulmonary edema, similar to a pattern of acute respiratory distress syndrome. A transthoracic echocardiogram (TTE) taken 2 hours after her admission to the MICU revealed a normal left ventricular (LV) chamber size with diffuse hypokinesia and an LV ejection fraction (LVEF) of approximately 0.30. No pericardial effusion was found. The initial complete blood counts, the blood chemistry results, and the toxicology screen were all normal. An intra-aortic balloon pump (IABP)-inserted about 3 hours after admission to the MICU-subsequently assisted, over the course of 4 days, with extracorporeal membrane oxygenation (ECMO) for cardiogenic shock.The patient's general condition improved substantially after therapeutic hypothermia, and she awoke on the 3rd day of hospitalization. On the 4th and 5th days, she was successfully weaned from the ECMO, the IABP, and the mechanical ventilator.

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“…Percutaneous coronary intervention of an anomalous coronary artery requires proper angiographic recognition of the anatomic details, such as the orifice configuration, exit angulation, and the route of the anomalous artery. In selected patients, a lesion in a LMCA of anomalous origin can be treated safely and successfully with percutaneous coronary intervention (Mirchandani and Phoon, 2005;Nef et al, 2007;Tejada et al,2007).…”

Section: Discussionmentioning

confidence: 99%

Successfull challenging percutaneous coronary interventions in two patients with anomalous left coronary artery origin from the right sinus of Valsalva

Demircan

Yüksel

2013

jecm

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Article HistoryReceived 30 / 11 / 2012 Accepted 16 / 01 / 2013Congenital anomalies of the coronary arteries affect about 1.3% of individuals. One of the most commonly encountered anomalies involves the anomalous origination of a coronary artery from the opposite sinus of Valsalva. The incidence of ectopic left coronary artery arising from the right sinus of Valsalva was found between 0.017-0.15% in coronary angiography and autopsy series. Catheter-based revascularization of anomalous artery is a therapeutic challenge and needs experience. In this case report, we demonstrated successful percutaneous coronary interventions to anomalous left main coronary artery osteal lesion and proximal lesion in anomalous left anterior descending artery in two patients with anomalous left coronary artery origin from right sinus of Valsalva.

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Stenting of anomalous left main coronary artery arising from the right sinus of Valsalva: A case report

Cited by 15 publications

References 7 publications

Right Coronary Artery Originating From the Left Coronary Sinus: A Rare Coronary Artery Anomaly

Right Coronary Artery Originating From the Left Coronary Sinus: A Rare Coronary Artery Anomaly

Sudden Cardiac Death Associated with Anomalous Origin of the Left Main Coronary Artery from the Right Sinus, with an Intramural Course

Successfull challenging percutaneous coronary interventions in two patients with anomalous left coronary artery origin from the right sinus of Valsalva

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