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Vol 13, No 5 (2018)
Case Reports
Published online: 2018-12-06
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Ectopic right coronary artery with high take-off: technical challenges during percutaneous coronary revascularization

Santosh Kumar Sinha, Mahmadula Razi, Mukesh Jitendra Jha, Vikas Mishra, Puneet Aggarwal, Anupam Singh, Lokendra Rekwal
DOI: 10.5603/FC.2018.0113
·
Folia Cardiologica 2018;13(5):461-465.

open access

Vol 13, No 5 (2018)
Case Reports
Published online: 2018-12-06

Abstract

Anomalies of the coronary arteries are reported in 1–2% of patients who undergo a diagnostic angiogram. An ectopic origin of the right coronary artery from the opposite sinus is one of these anomalies, and while most are benign, at times it may be malignant. We report the case of a 43-year-old female who underwent primary percutaneous coronary intervention for acute inferior wall myocardial infarction where an ectopically arising right coronary artery (RCA) with abnormally high take-off was the culprit. We describe the various technical challenges faced during intervention, from cannulation to tracking of hardware. The RCA was cannulated using the floating wire technique and revascularised by the deployment of a 3.5 × 33 mm Xience Prime drug-eluting stent (Abbott Vascular, Santa Clara, CA, USA). In such a scenario where a conventional technique fails and where door-to-balloon time must be kept as short as possible, a little improvisation should resolve the problem.

Abstract

Anomalies of the coronary arteries are reported in 1–2% of patients who undergo a diagnostic angiogram. An ectopic origin of the right coronary artery from the opposite sinus is one of these anomalies, and while most are benign, at times it may be malignant. We report the case of a 43-year-old female who underwent primary percutaneous coronary intervention for acute inferior wall myocardial infarction where an ectopically arising right coronary artery (RCA) with abnormally high take-off was the culprit. We describe the various technical challenges faced during intervention, from cannulation to tracking of hardware. The RCA was cannulated using the floating wire technique and revascularised by the deployment of a 3.5 × 33 mm Xience Prime drug-eluting stent (Abbott Vascular, Santa Clara, CA, USA). In such a scenario where a conventional technique fails and where door-to-balloon time must be kept as short as possible, a little improvisation should resolve the problem.

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Keywords

ectopic right coronary artery, floating wire technique, high take-off, primary percutaneous coronary interventio

About this article
Title

Ectopic right coronary artery with high take-off: technical challenges during percutaneous coronary revascularization

Journal

Folia Cardiologica

Issue

Vol 13, No 5 (2018)

Pages

461-465

Published online

2018-12-06

DOI

10.5603/FC.2018.0113

Bibliographic record

Folia Cardiologica 2018;13(5):461-465.

Keywords

ectopic right coronary artery
floating wire technique
high take-off
primary percutaneous coronary interventio

Authors

Santosh Kumar Sinha
Mahmadula Razi
Mukesh Jitendra Jha
Vikas Mishra
Puneet Aggarwal
Anupam Singh
Lokendra Rekwal

References (9)
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