Single Coronary Artery

Abstract

A s part of the workup for pulmonary hypertension, a 59-year-old man underwent coronary angiography. This demonstrated a single coronary artery arising from the right sinus of valsalva, which gave off 3 branches that supplied the entire left ventricle. Left ventricular function was normal by ventriculography. Angiography is often sufficient to define coronary anomalies; however, we found coronary computed tomography angiography useful to confirm this anomaly.Single coronary artery anomaly is rare, with incidence estimated at approximately 0.03%, and approximately 20 possible variations of single coronary artery have been described. Of these, antemortem reports of single coronary artery arising from the right sinus of valsalva are exceedingly rare. This anomaly would be classified according to Lipton's scheme as a variant of RII-A. A well-known case of this condition was that of a professional basketball player, who died suddenly while playing pick-up basketball. In that case, autopsy showed a single coronary artery arising from the right sinus of valsalva and a dilated cardiomyopathy. Prognosis of individuals with single coronary artery is unclear and no guidelines for treatment of this condition exist. Revascularization is recommended only if there is significant atherosclerosis and documented ischemia.

Unusual Cause for Pediatric Chest Pain: MDCT Evaluation of Single Coronary Artery

“…As an isolated finding it occurs in approximately 0.024% to 0.066% of the population. In association with certain other congenital anomalies, however, it is found considerably more frequently; the incidence in a series of 54 cases of persistent truncus arteriosus was 18.5% and in another paper it was reported to be 18% 4 ; in a study of coronary angiograms of 296 patients with Tetralogy of Fallot a single coronary artery was found in seven cases and in pulmonary atresia the incidence is around 17%. 2 In 1979, Lipton et al proposed a very useful angiographic classification'1', further modified in 1990 by Yamanaka and Hobbs.…”

Report on a rare single coronary artery anomaly: Need for comprehensive investigations

“…After performing autopsy, it was found that the athlete had single coronary artery arising from right sinus of Valsalva. [ 5 ] Among the diverse presentation of coronary anomaly, single coronary anomaly is an important rare anomaly that has been frequently associated with sudden death. There have been controversies regarding the prognosis following medical treatment or surgical treatment.…”

“…Apart from routine checkup for cardiovascular system, such as ECG, echocardiography, treadmill test, and others, we can particularly perform ventriculography to assess the functioning of ventricles which frequently comes out to be normal. [ 5 ] After determining the anomaly, the recent advancement of diagnostic techniques such as multislice CT and 3D construction if images are highly recommended to evaluate and confirm the subtypes and definitive anomaly that is present in a patient. [ 10 ]…”

A Combination of Two Rare Coronary Anomalies Makes It Even Rarer: Right Sided Single Coronary Artery with Dual Left Anterior Descending Artery

“…Because of its rarity there are currently no guidelines on the management of patients with SCA. Revascularization is indicated in cases of atherosclerotic CAD and ischemia [ 11 ]. Invasive management strategies in patients with SCA and atherosclerotic CAD are very rare and pose high risk since cannulation of common trunk by large catheter might be poorly tolerated given the fact that the whole heart gets its supply from that common single trunk [ 12 ].…”