J Transcat Intervent.2021;29:eA20210013.
Right or left? The choices of a single coronary artery
Gustavo Luís Agostini
, Denise Pellegrini
, Paulo Caramori
DOI: 10.31160/JOTCI202129A20210013
We present two cases of single coronary artery (SCA), an extremely rare congenital anomaly, in which only one artery arises from the aortic arch by a single coronary ostium, supplying the entire heart. This condition occurs only in 0.024% to 0.044% of population, and most cases are associated with other congenital anomalies, such as persistent ductus arteriosus, tetralogy of Fallot and pulmonary atresia. In a 2-week period, the two patients presented at the emergency department with non-ST segment elevation acute coronary syndrome.
The first patient was a 52-year-old female, with history of hypertension, diabetes, and idiopathic dilated cardiomyopathy evolving with heart failure and reduced ejection fraction, treated with both drug therapy and cardiac resynchronization. Coronary angiography showed a SCA originating from the right sinus of Valsalva, and no coronary stenosis (). Cardiac computed tomography (CCT) showed left main coronary artery with pre-pulmonary course and normal right coronary course ( and ), and the myocardial scintigraphy was normal.
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