Single coronary artery anomaly: Report of an extremely rare variation

Abstract

A 43-year-old man presented with unstable angina. Coronary angiography revealed a single coronary artery originating from the left sinus of Valsalva, giving rise to a left main stem trifurcating to the left anterior descending artery, left circumflex artery, and an anomalous right coronary artery. The anomalous right coronary artery had a retroaortic course and significant proximal tubular stenosis which was stented. The coronary anomaly and abnormal course was confirmed by transesophageal echocardiography. The patient was symptom-free at one-year follow-up. This anomaly does not predispose to accelerated atherosclerosis, and the premature atherosclerosis in our patient was probably due an unhealthy lifestyle.

Keywords

Coronary artery disease Coronary vessel anomalies Echocardiography transesophageal

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References

Yamanaka

Hobbs

. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990; 21: 28–40.

Zamani

Mahmmody

. Anomalous right coronary artery originating from the left main coronary artery. Iranian Cardiovascular Research Journal 2009; 3: 167–169. Available at: http://ircrj.com/9824.fulltext. Accessed November 20, 2015.

Shirani

Roberts

. Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies. J Am Coll Cardiol 1993; 21: 137–143.

Ogden

Goodyer

. Patterns of distribution of the single coronary artery. Yale J Biol Med 1970; 43: 11–21.

Giannoccaro

Sochowski

Morton

Chan

. Complementary role of transoesophageal echocardiography to coronary angiography in the assessment of coronary artery anomalies. Br Heart J 1993; 70: 70–74.

Fernandes

Alam

Smith

Khaja

. The role of transesophageal echocardiography in identifying anomalous coronary arteries. Circulation 1993; 88: 2532–2540.