Coronary artery disease in congenital single coronary artery in adults: A Dutch case series

Table 2 Clinical-significance-based classification of coronary artery anomalies by Rigatelli et al[19,20]

Class	Subtypes	Clinical significance	Current series
A	E.g., ectopic origin of Cx from RSV1	Benign natural history, asymptomatic careful follow-up with conservative medical management or percutaneous intervention	Patients: none1
B	Ectopic origin of Cx from the RCA	Relevant, related to myocardial ischemia	Patients: 1, 2, 3, 7, 8, 9, 12, 15
	R-I, R-II, R-III anterior/posterior course2	Careful follow-up with conservative medical management or percutaneous intervention
C	L-I, L-II, L-III anterior/posterior course2	Severe, potentially related to sudden cardiac death
	R-I, R-II, R-III between/interseptal course2	Requires surgical treatment	Patients: 6, 10, 13, 14
D	L-I, L-II, L-III between/interseptal course2	Critical, class B or C with superimposed coronary artery atherosclerotic disease	Patients: 4, 5, 11
	B or C subgroups with concomitant coronary atherosclerosis	Requires urgent percutaneous management or surgical treatment

¹Not included in the current paper;

²Classification according to Lipton et al[1]. Cx: Circumflex coronary artery; L: Left; R: Right; RCA: Right coronary artery; RSV: Right sinus of Valsalva.