Single coronary artery: Case report of an absent right coronary artery

A case of absent right coronary artery is reported in which post-mortem injection and roentgenography of the coronary arteries were performed.     

A case of coronary artery bypass grafting with right gastroepiploic artery for right coronary artery obstruction associated with aortitis syndrome

A case of a 66 year-old female with aortitis syndrome with right coronary arterial obstruction, was reported. The coronary arteriogram showed total occlusion of the right coronary artery (segment 2). On the aortogram, stenosis of the left common carotid artery, kinking and aneurysm of the descending thoracic aorta were revealed. Because she developed frequent attacks of effort angina and the descending thoracic aneurysm was small in diameter 38 mm, coronary bypass grafting to the right coronary artery was performed using the in situ right gastroepiploic artery. Postoperative course was not eventful and chest pain disappeared. In such cases, the right gastroepiploic artery is useful for coronary artery bypass grafting.     

An unusual presentation of right coronary artery fistula

A four year old girl with infective endocarditis had unexplained facial swelling. Cross sectional echocardiography showed that a large right coronary artery fistula to the right atrium was obstructing the distal superior vena cava. The diagnosis was confirmed by cardiac catheterisation and at operation. The child was symptom free one year after operation.     

Anomalous left anterior descending, absent circumflex and unusual dominant course of right coronary artery: a case report--R1

A 40-years-old female presented with atypical chest pain. Selective coronary angiography revealed separate osteal origin of anomalous left anterior descending (LAD) and normal origin of right coronary artery (RCA) from right anterior coronary sinus. LAD had a septal course. Left circumflex (LCx) was absent. RCA, a dominant vessel, continued beyond the crux, along the entire length of atrioventricular groove as circumflex artery. There was no myocardial ischemia on stress thallium. As per our knowledge, this type of combination of anatomical variation of coronary circulation has not been described in the literature.     

Triple origin of left coronary arteries from right coronary artery: Unusual case of single coronary artery

A rare case of coronary anomaly is presented: all of the coronary arteries originated from a single ostium located in the right coronary cusp. No clinical evidence of coronary pathology was recognized until the age of 57 years when the patient was found to have coronary obstructive disease. The single coronary artery had a main branch corresponding to the usual dominant right coronary artery. Three other branches separated from this and vascularized the areas normally receiving the circumflex and ramus medianus, the left anterior descending, and a large septal branch.     

Stenting of an anomalous left circumflex coronary artery arising from the right coronary artery

Coronary angioplasty can provide excellent means of revascularization of anomalous coronary arteries. Successful application of angioplasty to these vessels requires angiographic knowledge of their course, structure and appropriate equipment selection. Advancement of stent delivery systems in such cases requires good support with the possibility of selective cannulation and deep engagement of the guiding catheter. We report a case of stent placement in an anomalous circumflex artery arising from the right coronary artery.     

An unusual presentation of right coronary artery fistula.

A four year old girl with infective endocarditis had unexplained facial swelling. Cross sectional echocardiography showed that a large right coronary artery fistula to the right atrium was obstructing the distal superior vena cava. The diagnosis was confirmed by cardiac catheterisation and at operation. The child was symptom free one year after operation.     

Dual right coronary artery associated coronary artery fistula

A 43-year-old man was admitted in our hospital for recurrentchest pain, breathlessness, and fatigue on exertion. Primarydiagnosis was coronary atherosclerotic heart disease. Detailedphysical examination, electrocardiogram (ECG), Chest X-ray,and     

Intra-atrial course of right coronary artery: A case report

BACKGROUNDIntra-atrial right coronary artery (RCA) is a rare and generally asymptomatic anomaly of development of the coronary arteries. This malformation could potentially expose the patient to a catastrophic outcome in the case of injury during interventional or surgical procedures. Currently, only a few case reports and no systematic reviews are available in the literature.CASE SUMMARYWe report the case of a 54-year-old man with atypical chest pain who underwent multi-detector computed tomography angiography (MDCTA). The exam revealed no significant coronary artery stenoses; however, an intra-atrial course of mid RCA was evident. Medical therapy was administered, and the patient was discharged to home without undergoing a conventional angiography. Previously reported autoptic and clinical cases were retrieved from the PubMed literature database to compare the clinicopathological features of this case.CONCLUSIONMDCTA depicted the abnormal course of the coronary artery in this patient as an intra-atrial course of the mid RCA. Finding this abnormality was crucial to avoid an inadvertent injury during interventional or surgical procedures.     

Supernumerary right coronary artery

A rare case of a patient with supernumerary right coronary artery in whom the two vessels arose from the right coronary sinus from two separate ostia adjacent to each other is presented. The smaller vessel gave off the sinoatrial nodal branch and the posterior descending artery whereas the larger one gave off the conus branch, the right ventricular branches, and continued as acute marginal branch. This is the first case report in the English literature.     

成人右冠状动脉起源于肺动脉一例

1病例资料患者女性,48岁,因“反复活动后胸痛1个月”入院。否认既往有心脏病、高血压及糖尿病病史。入院后体检：BP：121／60mmHg（1mmHg=0．133kPa）,HR：80次／min,律齐,无病理性杂音,双肺呼吸音清,未闻及干湿性哕音,腹软,无压痛,双下肢无水肿。心电图示：正常窦性心律。超声心动图示：右冠状动脉明显增宽（O．8cm）,少中量二尖瓣反流。     

The sinister course of an intramural right coronary artery

We report the case of an adolescent who was presented with long-standing exertional symptoms, and was diagnosed with an anomalous right coronary arterial origin arising above the commissural junction between the left and right aortic sinus, with inter-arterial and intramural compression. The precise origin of this lesion outside the aortic sinuses is unusual, and multi-detector computed tomography gave excellent definition and spatial resolution of the anomalous origin and course. It is crucial to have a high index of suspicion of exertional symptoms, as sudden death may be the first manifestation of an anomalous coronary artery.     

Intracavitary right coronary artery

Congenital coronary artery anomalies have been reported in fewer than 1.3% of patients undergoing coronary angiography. Most commonly, they take the form of an anomalous origin of one of the major epicardial vessels or variations in their epicardial course. The presence of an intracavitary course of an intact epicardial coronary artery is a particularly rare entity with two distinct variants described in the literature. While the majority of previous reports were incidentally encountered at the time of open heart surgery or on autopsy, the detection of these abnormalities is likely to significantly increase with the widespread use of advanced cardiac imaging. Although usually clinically benign, these variants impose a myriad of challenges around invasive cardiac procedures. The presence of an intramural or intracavitary course can complicate coronary artery bypass surgery, leading to difficulties in vessel localization as well as bypass grafting. In addition, it is of upmost importance that interventional cardiologists and electrophysiologists are aware of this anomaly because inadvertent disruption of an intracavitary artery can occur at the time of invasive coronary angiography, pacemaker implantation, right heart catheterization or electrophysiology procedure. Electrophysiologists, invasive cardiologists and cardiothoracic surgeons all need to be aware of this anomaly and the implications of this anatomical variant on procedural risk and planning.     

Posterior myocardial infarction caused by superdominant circumflex occlusion over an absent right coronary artery: Case report and review of literature

Rationale:Congenital agenesis of the right coronary artery (CARCA) initially presenting as acute myocardial infarction (AMI) due to total occlusion is a rare clinical condition that can lead to severe complications, including death. We report a case of successful percutaneous coronary intervention (PCI) in a patient with this condition.Patient concerns:A 57-year-old man was admitted to our center with chest pain that had occurred several hours prior. Since he was initially diagnosed with AMI with ST-segment elevation, we promptly commenced coronary angiography (CAG).Diagnosis:CAG revealed the absence of a right coronary artery (RCA). In the left coronary cusp area, the left circumflex coronary artery (LCX) was occluded totally.Interventions:We performed PCI for total occlusion of the proximal part of the LCX. Follow-up CAG showed a superdominant branch of the LCX, sprouting into the RCA territory.Outcomes:The patient was discharged uneventfully after successful PCI.Lessons:CARCA with AMI, which is an extremely unusual case, can be fatal; however, PCI seems to be an effective treatment option.