open access

Ahead of Print
Case report
Submitted: 2023-06-01
Accepted: 2023-07-10
Published online: 2023-08-04
Get Citation

Rare case of single left coronary artery in a Japanese cadaver

Hayato Terayama12, Osamu Tanaka1, Daisuke Kiyoshima1, Ning Qu21, Kenta Nagahori12, Yoko Ueda12, Kaori Suyama1, Kou Sakabe123
Affiliations
  1. Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, Kanagawa, Japan
  2. Department of Anatomy, Tokyo Medical University, Tokyo, Japan
  3. Department of Environmental Preventive Medicine, Yamada Bee Company, Inc., Center for Preventive Medical Sciences, Chiba University, Chiba, Japan

open access

Ahead of Print
CASE REPORTS
Submitted: 2023-06-01
Accepted: 2023-07-10
Published online: 2023-08-04

Abstract

A single left coronary artery with a single orifice in the left aortic sinus was observed during anatomical practice in an 81-year-old male Japanese cadaver. The single left coronary artery bifurcated into the anterior interventricular branch (IVa) and circumflex (CXa) branches. The IVa descended into the anterior interventricular sulcus to supply the apex of the heart, leaving a branch that traversed the upper part of the infundibulum to supply the anterior upper region of the right ventricle. The CXa curved leftward in the atrioventricular sulcus to reach the posterior surface, after which it continued to emerge into the anterior surface. The vascular running pattern showed that CXa directly supplied blood to the upper right ventricle (but not the conus branch), with three branches connected to the apex. The atrial arteries showed no anomalous distribution patterns. These findings are useful during surgical procedures, including cardiac catheterization.

Abstract

A single left coronary artery with a single orifice in the left aortic sinus was observed during anatomical practice in an 81-year-old male Japanese cadaver. The single left coronary artery bifurcated into the anterior interventricular branch (IVa) and circumflex (CXa) branches. The IVa descended into the anterior interventricular sulcus to supply the apex of the heart, leaving a branch that traversed the upper part of the infundibulum to supply the anterior upper region of the right ventricle. The CXa curved leftward in the atrioventricular sulcus to reach the posterior surface, after which it continued to emerge into the anterior surface. The vascular running pattern showed that CXa directly supplied blood to the upper right ventricle (but not the conus branch), with three branches connected to the apex. The atrial arteries showed no anomalous distribution patterns. These findings are useful during surgical procedures, including cardiac catheterization.

Get Citation

Keywords

cadaver, single coronary artery, left coronary artery, anatomical variant, circumflex

About this article
Title

Rare case of single left coronary artery in a Japanese cadaver

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2023-08-04

Page views

232

Article views/downloads

143

DOI

10.5603/FM.a2023.0052

Pubmed

37622395

Keywords

cadaver
single coronary artery
left coronary artery
anatomical variant
circumflex

Authors

Hayato Terayama
Osamu Tanaka
Daisuke Kiyoshima
Ning Qu
Kenta Nagahori
Yoko Ueda
Kaori Suyama
Kou Sakabe

References (23)
  1. Akcay A, Tuncer C, Batyraliev T, et al. Isolated single coronary artery: a series of 10 cases. Circ J. 2008; 72(8): 1254–1258.
  2. Allen GL, Snider TH. Myocardial infarction with a single coronary artery. Report of a case. Arch Intern Med. 1966; 117(2): 261–264.
  3. Antonellis J, Rabaouni A, Kostopoulos K, et al. Single coronary artery from the right sinus of Valsalva, associated with absence of left anterior descending and an ostium-secundum-type atrial septal defect: a rare combination. A case report. Angiology. 1996; 47(6): 621–625.
  4. Austen WG, Edwards JE, Frye RL, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975; 51(4 Suppl): 5–40.
  5. Cheitlin MD, De Castro CM, McAllister HA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva, A not-so-minor congenital anomaly. Circulation. 1974; 50(4): 780–787.
  6. Desmet W, Vanhaecke J, Vrolix M, et al. Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J. 1992; 13(12): 1637–1640.
  7. Fernandes ED, Kadivar H, Hallman GL, et al. Congenital malformations of the coronary arteries: the Texas Heart Institute experience. Ann Thorac Surg. 1992; 54(4): 732–740.
  8. Hillestad L, Eie H. Single coronary artery. A report of three cases. Acta Med Scand. 1971; 189(5): 409–413.
  9. Iwanaga J, Singh V, Ohtsuka A, et al. Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat. 2021; 34(1): 2–4.
  10. Kelley MJ, Wolfson S, Marshall R. Single coronary artery from the right sinus of Valsalva: angiography, anatomy, and clinical significance. AJR Am J Roentgenol. 1977; 128(2): 257–262.
  11. Koizumi M, Kawai K, Honma S, et al. Anatomical study of a left single coronary artery with special reference to the various distribution patterns of bilateral coronary arteries. Ann Anat. 2000; 182(6): 549–557.
  12. Larsen WJ. Translation of Human Embryology, 2nd ed, Japanese ed. Nishimura Co., Tokyo 1999.
  13. Lipton MJ, Barry WH, Obrez I, et al. Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology. 1979; 130(1): 39–47.
  14. McAlpine W. Heart and coronary arteries. An anatomical atlas for clinical diagnosis, radiological investigation, and surgical treatment. Springer, Berlin 1975: 133–209.
  15. Murai T, Kawaguchi Y, Inui M. Anomalous origin of the left coronary artery. Acta Pathol Jpn. 1982; 32(6): 1075–1083.
  16. Ogden JA, Goodyer AV. Patterns of distribution of the single coronary artery. Yale J Biol Med. 1970; 43(1): 11–21.
  17. Shammas RL, Miller MJ, Babb JD. Single left coronary artery with origin of the right coronary artery from distal circumflex. Clin Cardiol. 2001; 24(1): 90–92.
  18. Sharma B, Chang A, Red-Horse K. Coronary artery development: progenitor cells and differentiation pathways. Annu Rev Physiol. 2017; 79: 1–19.
  19. Shirani J, Roberts WC. Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies. J Am Coll Cardiol. 1993; 21(1): 137–143.
  20. Stroobandt R, Piessens J, Suy R, et al. Unstable angina pectoris in single coronary artery. Acta Cardiol. 1974; 29(6): 469–475.
  21. Tuncer C, Batyraliev T, Yilmaz R, et al. Origin and distribution anomalies of the left anterior descending artery in 70,850 adult patients: multicenter data collection. Catheter Cardiovasc Interv. 2006; 68(4): 574–585.
  22. Warren SE, Alpert JS, Vieweg WV, et al. Normal single coronary artery and myocardial infarction. Chest. 1977; 72(4): 540–543.
  23. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990; 21(1): 28–40.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl