Rare case of single left coronary artery in a Japanese cadaver
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.
Keywords: cadaversingle coronary arteryleft coronary arteryanatomical variantcircumflex
References
- Akcay A, Tuncer C, Batyraliev T, et al. Isolated single coronary artery: a series of 10 cases. Circ J. 2008; 72(8): 1254–1258.
- Allen GL, Snider TH. Myocardial infarction with a single coronary artery. Report of a case. Arch Intern Med. 1966; 117(2): 261–264.
- 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.
- 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.
- 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.
- 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.
- 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.
- Hillestad L, Eie H. Single coronary artery. A report of three cases. Acta Med Scand. 1971; 189(5): 409–413.
- 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.
- 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.
- 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.
- Larsen WJ. Translation of Human Embryology, 2nd ed, Japanese ed. Nishimura Co., Tokyo 1999.
- Lipton MJ, Barry WH, Obrez I, et al. Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology. 1979; 130(1): 39–47.
- McAlpine W. Heart and coronary arteries. An anatomical atlas for clinical diagnosis, radiological investigation, and surgical treatment. Springer, Berlin 1975: 133–209.
- Murai T, Kawaguchi Y, Inui M. Anomalous origin of the left coronary artery. Acta Pathol Jpn. 1982; 32(6): 1075–1083.
- Ogden JA, Goodyer AV. Patterns of distribution of the single coronary artery. Yale J Biol Med. 1970; 43(1): 11–21.
- 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.
- Sharma B, Chang A, Red-Horse K. Coronary artery development: progenitor cells and differentiation pathways. Annu Rev Physiol. 2017; 79: 1–19.
- 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.
- Stroobandt R, Piessens J, Suy R, et al. Unstable angina pectoris in single coronary artery. Acta Cardiol. 1974; 29(6): 469–475.
- 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.
- Warren SE, Alpert JS, Vieweg WV, et al. Normal single coronary artery and myocardial infarction. Chest. 1977; 72(4): 540–543.
- Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990; 21(1): 28–40.
