open access

Vol 25, No 6 (2018)
Original articles — Interventional cardiology
Published online: 2017-12-01
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Anomalous origin of culprit coronary arteries in acute coronary syndromes

Paweł Tyczyński, Krzysztof Kukuła, Arkadiusz Pietrasik, Tomasz Bochenek, Artur Dębski, Anna Oleksiak, Miłosz Marona, Michał Lelek, Janina Stępińska, Adam Witkowski
DOI: 10.5603/CJ.a2017.0142
·
Pubmed: 29240961
·
Cardiol J 2018;25(6):683-690.

open access

Vol 25, No 6 (2018)
Original articles — Interventional cardiology
Published online: 2017-12-01

Abstract

Background: The aim of the study was to describe a series of acute coronary syndrome (ACS) patients in whom anomalous origin of culprit coronary artery (AOCCA) was diagnosed. Percutaneous coronary interventions (PCI) in AOCCA are performed very infrequently.

Methods: Electronic databases from three high-volume tertiary cardiac centers were retrospectively searched for the presence of AOCCA in ACS.

Results: Different types of AOCCA in ACS were identified in 20 patients. The most frequent AOCCA was left circumflex coronary artery (LCx) originating from right coronary artery (RCA) or directly from the right coronary sinus (RCS), n = 13, followed by high/atypical RCA, n = 3, left coronary artery (LCA) originating from RCS (n = 3) with either RCA-AOCCA (n = 1) or left anterior descending coronary artery (LAD)-AOCCA (n = 1) or RCA originating from left sinus of Valsalva, (n = 1), LAD originating from RCA (n = 1). In 1 ST-segment elevation myocardial infarction (STEMI)-patient RCA-AOCCA cannulation was unsuccessful, in 1 non-STEMI-patient AOCCA was missed, 1 ACS- -patient was treated surgically and 1 ACS-patient was treated conservatively (both patients with non- STEMI). In the remaining patients PCI was successfully performed.

Conclusions: The most frequently encountered AOCCA is LCx branching-off from RCA. AOCCA may either be difficult to cannulate and PCI aborted even in STEMI, or missed, especially when the intermediate branch from LCA is mimicking proper LCx.

Abstract

Background: The aim of the study was to describe a series of acute coronary syndrome (ACS) patients in whom anomalous origin of culprit coronary artery (AOCCA) was diagnosed. Percutaneous coronary interventions (PCI) in AOCCA are performed very infrequently.

Methods: Electronic databases from three high-volume tertiary cardiac centers were retrospectively searched for the presence of AOCCA in ACS.

Results: Different types of AOCCA in ACS were identified in 20 patients. The most frequent AOCCA was left circumflex coronary artery (LCx) originating from right coronary artery (RCA) or directly from the right coronary sinus (RCS), n = 13, followed by high/atypical RCA, n = 3, left coronary artery (LCA) originating from RCS (n = 3) with either RCA-AOCCA (n = 1) or left anterior descending coronary artery (LAD)-AOCCA (n = 1) or RCA originating from left sinus of Valsalva, (n = 1), LAD originating from RCA (n = 1). In 1 ST-segment elevation myocardial infarction (STEMI)-patient RCA-AOCCA cannulation was unsuccessful, in 1 non-STEMI-patient AOCCA was missed, 1 ACS- -patient was treated surgically and 1 ACS-patient was treated conservatively (both patients with non- STEMI). In the remaining patients PCI was successfully performed.

Conclusions: The most frequently encountered AOCCA is LCx branching-off from RCA. AOCCA may either be difficult to cannulate and PCI aborted even in STEMI, or missed, especially when the intermediate branch from LCA is mimicking proper LCx.

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Keywords

anomalous origin culprit coronary artery, percutaneous coronary intervention, acute coronary syndrome

About this article
Title

Anomalous origin of culprit coronary arteries in acute coronary syndromes

Journal

Cardiology Journal

Issue

Vol 25, No 6 (2018)

Pages

683-690

Published online

2017-12-01

DOI

10.5603/CJ.a2017.0142

Pubmed

29240961

Bibliographic record

Cardiol J 2018;25(6):683-690.

Keywords

anomalous origin culprit coronary artery
percutaneous coronary intervention
acute coronary syndrome

Authors

Paweł Tyczyński
Krzysztof Kukuła
Arkadiusz Pietrasik
Tomasz Bochenek
Artur Dębski
Anna Oleksiak
Miłosz Marona
Michał Lelek
Janina Stępińska
Adam Witkowski

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