Published online Aug 6, 2019. doi: 10.12998/wjcc.v7.i15.2128
Peer-review started: March 28, 2019
First decision: May 31, 2019
Revised: June 24, 2019
Accepted: July 3, 2019
Article in press: July 4, 2019
Published online: August 6, 2019
Processing time: 133 Days and 1.2 Hours
Single coronary artery (SCA) originating from a solitary ostium in the aorta and perfusing the entire myocardium is a very rare congenital anomaly of the coronary artery. Furthermore, a right coronary artery (RCA) arising from the mid segment of the left anterior descending artery (LAD) is an extremely uncommon variation of SCA.
A 76-year-old woman presented a 5-mo history of exertional angina. Selective coronary angiography revealed an SCA, with severe ostial stenosis that originated from the left sinus of Valsalva and bifurcated normally into the LAD and circumflex coronary artery. In addition, an anomalous RCA originated from the mid segment of the LAD as a separate branch. Successful balloon angioplasty and stenting for the SCA ostial stenosis were performed on the patient.
Percutaneous coronary intervention (PCI) of the main trunk for SCA is very similar to PCI of an unprotected left main coronary artery. Although technical difficulties and risks do exist, PCI for severe ostial stenosis of the main trunk is safe and efficacious in selected SCA patients.
Core tip: The right coronary artery arising from the mid segment of the left anterior descending artery is an extremely uncommon variation of single coronary artery (SCA). In this report, a 76 year-old female presented a 5-month history of exertional angina. Selective coronary angiography revealed an SCA, with severe ostial stenosis. Successful balloon angioplasty and stenting for the SCA ostial stenosis were performed on this case. Although technical difficulties and definite risk do exist, percutaneous coronary intervention for severe ostial stenosis of main trunk is safe and efficacious in selected SCA cases.