Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2019; 7(15): 2128-2133
Published online Aug 6, 2019. doi: 10.12998/wjcc.v7.i15.2128
Percutaneous coronary intervention for ostial lesions of the left main stem in a patient with congenital single left coronary artery: A case report
Qiang Wu, Zong-Zhuang Li, Feng Yue, Fang Wei, Chen-Yun Zhang
Qiang Wu, Zong-Zhuang Li, Feng Yue, Fang Wei, Chen-Yun Zhang, Department of Cardiology, Guizhou Provincial People’s Hospital, Guiyang, 550002, Guizhou Province, China
Author contributions: Wu Q, Li ZZ, Yue F, Wei F, and Zhang CY wrote and proofread this manuscript.
Supported by "100" Level Talent Plan of Guizhou High-level Innovative Talent Training Program, No. 2016-4023; and Guizhou Province Clinical Research Centre for Cardiovascular Diseases, No. 2017-5405.
Informed consent statement: The patient gave informed consent for the publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The manuscript was revised according to the CARE checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chen-Yun Zhang, MD, Chief Physician, Department of Cardiology, Guizhou Provincial People’s Hospital, No. 83, East Zhongshan Road, Guiyang 550002, Guizhou Province, China. cyzhang5828@163.com
Telephone: +86-851-85937213 Fax: +86-851-85937213
Received: March 27, 2019
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Coronary anomaly; Single coronary artery; Left main coronary artery; Percutaneous coronary intervention; Case report

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.