Congenital absence of the right coronary artery with acute myocardial infarction: report of two cases and review of the literature

Abstract

Congenital absence of the right coronary artery (RCA) is a rare coronary anomaly. Few cases of this condition have been reported. Congenital absence of the RCA is considered as a benign anomaly. However, in certain cases, these patients may develop life-threatening clinical complications that include acute myocardial infarction, stroke, or sudden death. We report two patients who were diagnosed with congenital absence of the RCA and presented with acute myocardial infarction. We discuss our experience in diagnosis and treatment of this disease. Congenital absence of the RCA with acute myocardial infarction is an uncommon clinical emergency. Therefore, early detection, correct diagnosis, and appropriate treatment are important.

Posterior myocardial infarction caused by superdominant circumflex occlusion over an absent right coronary artery

“…Based on this literature review, several reported cases of successful PCI for MI in patients with L-I type CARCA. [ 7 , 9 , 10 , 27 , 28 ] However, there are very few cases of PCI for total occlusion of the proximal LCA in patients with this malformation. [ 7 ] This is the first reported case of PCI for total occlusion of the proximal LCX in a patient with L-I type CARCA confirmed on both CAG and coronary CTA.…”

“…[ 7 , 9 , 10 , 27 , 28 ] However, there are very few cases of PCI for total occlusion of the proximal LCA in patients with this malformation. [ 7 ] This is the first reported case of PCI for total occlusion of the proximal LCX in a patient with L-I type CARCA confirmed on both CAG and coronary CTA. Since CARCA is a very rare condition, various modalities should be applied to discriminate it from similar other cardiovascular malformations.…”

“…[19,20] In a PubMed search for cases of CARCA published from January 2011 to December 2020, a total of 38 cases were found in 34 articles (Table 1). [7,[21][22][23][24][25][26][27][28][29] Among these cases, a total of 22 patients were male, 13 were diagnosed with MI, and 15 underwent PCI or CABG. Furthermore, 29 cases showed L-I type CARCA.…”

“…[ 2 , 4 , 6 ] In some reported cases, percutaneous coronary intervention (PCI) was performed. [ 7 – 10 ]…”

“…[2,4,6] In some reported cases, percutaneous coronary intervention (PCI) was performed. [7][8][9][10] Herein, we describe an extremely unusual case of a patient with CARCA and MI who was successfully treated with PCI for total occlusion of the left circumflex coronary artery (LCX). Our study was conducted according to the ethical standard of the Declaration of Helsinki.…”