Vol 14, No 4 (2019)
Case report
Published online: 2019-06-17
Anomalous right coronary artery from the left aortic sinus: technical issues during revascularisation
Folia Cardiologica 2019;14(4):392-396.
Abstract
Anomalies of the coronary arteries are reported in 1–2% of patients subject to a diagnostic angiogram. Ectopic origin
of right coronary artery from the opposite sinus is one of the most common, and while mainly benign, at times may be
malignant. We report the case of a 72 year-old male who underwent percutaneous coronary intervention for chronic
stable angina who had a critically diseased obtuse marginal branch, and an anomalous right coronary artery (RCA) arising
from the left aortic sinus on coronary angiogram, and various technical challenges during the procedure. RCA was
cannulated using a Judkins left guiding catheter and revascularised by deployment of a 2.75 × 18 mm Promus Premier
Stent (everolimus-eluting stent, Boston Scientific, USA) at 12 atm.
Keywords: anomalous right coronary arterychronic stable anginaJudkins left guiding catheter
References
- Click RL, Holmes DR, Vlietstra RE, et al. Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival--a report from the Coronary Artery Surgery Study. J Am Coll Cardiol. 1989; 13(3): 531–537.
- Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990; 21(1): 28–40.
- Angelini P, Villason S, Chan AV. Normal and anomalous coronary arteries in humans. In: Angelini P. ed. Coronary Artery Anomalies: A Comprehensive Approach. Lippincott Williams & Wilkins, Philadelphia 1999: 42.
- Yans J, Kumar SP, Kwatra M. Anomalous origin of the right coronary artery above the left sinus of Valsalva. Cathet Cardiovasc Diagn. 1978; 4(4): 407–412.
- Husaini SN, Beaver WL, Wilson IJ, et al. Anomalous right coronary artery arising from left mainstem. Cathet Cardiovasc Diagn. 1983; 9(4): 407–409.
- Topaz O, DiSciascio G, Goudreau E, et al. Coronary angioplasty of anomalous coronary arteries: notes on technical aspects. Cathet Cardiovasc Diagn. 1990; 21(2): 106–111.
- Musial B, Schob A, de Marchena E, et al. Percutaneous transluminal coronary angioplasty of anomalous right coronary artery. Cathet Cardiovasc Diagn. 1991; 22(1): 39–41.
- Chakraborty B, Chan CN, Tan A. Percutaneous transluminal coronary angioplasty of an anomalous right coronary artery arising from a separate ostium in the left sinus of Valsalva. A case report. Angiology. 1995; 46(7): 629–632.
- Sarkar K, Sharma SK, Kini AS. Catheter selection for coronary angiography and intervention in anomalous right coronary arteries. J Interv Cardiol. 2009; 22(3): 234–239.
- Mooss AN, Heintz MH. Percutaneous transluminal angioplasty of anomalous right coronary artery. Cathet Cardiovasc Diagn. 1989; 16(1): 16–18.
