Transluminal angioplasty of a single coronary artery

Percutaneous Coronary Revascularization in Patients With Single Coronary Artery

INTRODUCTION

Single coronary artery (SCA) is a rare congenital coronary anomaly. Its incidence in various angiographic series is from 0.024% to 0.066%. Percutaneous coronary intervention (PCI) of coronary artery disease (CAD) in these patients is technically challenging.

METHODS

We retrospective analyzed the cardiac catheterization procedures of last 15 years and found 12 cases of SCA (incidence 0.084%). To determine the course of anomalous coronaries, angiographic "dot and eye" method and computed tomography (CT) were used. The course of the SCA was classified as per the modified Lipton criteria. PCI was performed as per the standard protocol for a significant epicardial coronary artery stenosis.

RESULTS

Out of total 12 patients of SCA, 9 patients had PCI of significant CAD. The mean age of 9 PCI patients was 63.8 ± 8.2 years (5 males, 4 females). The origin of the SCA was from the right sinus of Valsalva in 6 cases and from left sinus of Valsalva in 3 cases. Eleven successful PCI procedures were performed, which included PCI of left main, coronary bifurcation lesion, chronic total occlusion, and multi-vessel disease. Four patients had intravascular imaging and 3 patients had rotablation of calcified lesions.

CONCLUSION

PCI of SCA is technically challenging, which requires considerable expertise and experience. An appropriate selection of hardware along with technical expertise can make the procedure simpler with optimal end results.

Transluminal angioplasty in a patient with a single coronary artery during the acute phase of a myocardial infarction

The prevalence of coronary artery abnormalities, in particular the single vessel form, is low among the general population. We report a case of a transluminal angioplasty of the left anterior descending artery arising from the right coronary artery during the acute phase of myocardial infarction.

Direct stenting in single coronary artery arising from the left sinus of Valsalva--a case report

A patient with postinfarction angina was referred for coronary angiography. In addition to severe atherosclerotic coronary disease, which was responsible for clinical presentation, a single coronary artery arising from the left sinus of Valsalva was found. The authors report the use of direct coronary stent deployment without predilation to treat disease in this rare anomaly.

Percutaneous transluminal coronary angioplasty of an anomalous right coronary artery arising from a separate ostium in the left sinus of Valsalva. A case report

The authors describe a case of angioplasty in an anomalous right coronary artery arising from an aberrant ostium in the left sinus of Valsalva anterior and slightly superior to the ostium of the left main coronary artery. The patient also had associated bicuspid aortic valve. To the best of their knowledge, this is the first case of angioplasty in an aberrant right coronary artery originating from an ectopic ostium. The choice of guiding catheter and balloon angioplasty catheter is discussed.

Percutaneous transluminal angioplasty of coronary arteries with anomalous origin

Coronary angioplasty to diseased anomalous coronary arteries is being more readily applied in revascularization of these vessels. Several cases of angioplasty have been described in various coronary anomalies. Probably more attempts of PTCA to anomalous coronary arteries are performed but not reported. For this reason, we cannot assume that the success rate is the same as in "normal" origin arteries or which complications occurred, including the need for coronary bypass. Although not yet reported, in some instances other techniques, such as laser atherectomy and coronary stents, may be applied, provided the artery is not tortuous, as it may be in some anomalous coronaries. The key to a successful procedure depends on angiographic knowledge of their course and appropriate equipment selection.

Transluminal angioplasty of a single coronary artery anomaly during acute myocardial infarction--a case report

This report describes successful angioplasty of a total coronary occlusion in a single-ostium coronary anomaly in a patient presenting with an acute myocar dial infarction.

Percutaneous transluminal coronary angioplasty of a right coronary artery arising from the left main coronary artery

Angioplasty of anomalous coronary arteries presents unique technical challenges. Correct guiding catheter selection is important to ensure adequate access to the anomalous vessel and to provide support to cross the lesion. A case of successful PTCA of a lesion in an anomalous right coronary artery arising from the left main coronary artery is presented.

Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies

OBJECTIVES

This study examines the distribution patterns and the clinical significance of the "solitary coronary ostium" in the aorta in the absence of other major congenital cardiovascular anomalies.

BACKGROUND

Ogden in 1970 classified "single coronary artery" into 14 basic distribution patterns. Since then, other patterns of distribution of single coronary artery have been recognized. Distinction has also been made between the cases with and without other major congenital cardiovascular anomalies or coronary artery atresia and those without these additional abnormalities. Single coronary artery has been generally considered to be a benign clinical entity.

METHODS

This study describes 10 cases of single coronary artery at necropsy and reviews 87 previously reported cases, 35 diagnosed at necropsy and 52 by coronary angiography.

RESULTS

We classified single coronary artery into 20 categories on the basis of the location of the solitary coronary ostium, the presence or absence of an aberrant-coursing coronary artery and the course taken by the aberrant-coursing coronary artery. When atherosclerotic coronary artery disease was absent, 15% (8 of 53) of the patients reviewed with single coronary artery had myocardial ischemia as a direct consequence of the coronary anomaly.

CONCLUSIONS

The anatomic classification presented is useful from both clinical and surgical viewpoints. This comprehensive classification of this rare anomaly facilitates description of the various distribution patterns of single coronary artery and their clinical significance.