Metrics

  • citations in SCIndeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[]
  • visits in previous 30 days:1
  • full-text downloads in 30 days:0

Contents

article: 2 from 26  
Back back to result list
2020, vol. 77, iss. 5, pp. 549-555
Primary percutaneous intervention of the right coronary artery in a setting of anomalous origination of left coronary artery from the opposite sinus of Valsalva
aUniversity of Belgrade, Faculty of Medicine, Institute of Cardiovascular Diseases 'Dedinje' + University of Belgrade, Faculty of Medicine
bUniversity of Belgrade, Faculty of Medicine, Institute of Cardiovascular Diseases 'Dedinje'
cUniversity of Belgrade, Faculty of Medicine + Military Medical Academy, Belgrade
dMilitary Medical Academy, Belgrade

emailsborovic2001@yahoo.com
Abstract
Introduction. Coronary artery anomalies are infrequent but anticipated findings during percutaneous coronary interventions (PCI). Compared to consistent reporting in angiographic series, they seem to be underreported in interventional studies, and particularly in the setting of primary PCI, where their prompt recognition is of the utmost importance. Case report. We present a 50 years old male with inferior ST-elevation of myocardial infarction (STEMI) and right ventricular involvement with solitary ostium for all three coronary arteries in the right aortic sinus of Valsalva. The patient had an extremely rare variant of coronary artery origination belonging to the type A4b2c2 of Angelini's classification. Correspondingly, it belongs to the left Anomalous origination of a Coronary Artery from the Opposite Sinus of Valsalva (ACAOS) class with the intraseptal course of left anterior descending artery. We managed successfully to implant a drug eluting stent in the proximal right coronary artery in a lengthy and stormy procedure, with the need for guiding catheter exchange, temporary pacing and dealing with no-reflow phenomenon. Conclusion. We summarize diagnostic hints for angiographic recognition of dominant variants of the left ACAOS and practical aspects of performing PCI in such patients. Also, we debate on the functional significance of coronary anomalies and its further implications from the prognostic and therapeutic aspects. We propose adoption of the novel classification of coronary anomalies of Angelini's group in the routine clinical practice. Finally, we call for the inclusion of specific training in coronary artery anomalies into the interventional cardiology fellowship curriculum.
References
Angelini, P., Walmsley, R.P., Libreros, A., Ott, D.A. (2006) Symptomatic anomalous origination of the left coronary artery from the opposite sinus of Valsalva: Clinical presentations, diagnosis, and surgical repair. Texas Hear Inst J, 33(2): 171-9
Angelini, P. (2015) ACAOS is better revealed by intravascular ultrasonography than by computed tomographic angiography. Texas Heart Institute Journal, 42(3): 246-247
Angelini, P. (2014) Novel imaging of coronary artery anomalies to assess their prevalence, the causes of clinical symptoms, and the risk of sudden cardiac death. Circulation: Cardiovascular Imaging, 7(4): 747-754
Angelini, P. (2002) Coronary artery anomalies: Current clinical issues: Definitions, classification, incidence, clinical relevance, and treatment guidelines. Tex Heart Inst J, 29(4): 271-8
Angelini, P. (2009) Anomalous origin of the left coronary artery from the opposite sinus of Valsalva: Typical and atypical features. Tex Heart Inst J, 36(4): 313-5
Angelini, P., Velasco, J.A., Ott, D., Khoshnevis, G.R. (2003) Anomalous coronary artery arising from the opposite sinus: Descriptive features and pathophysiologic mechanisms, as documented by intravascular ultrasonography. J Invasive Cardiol, 15(9): 507-14
Angelini, P. (2007) Coronary artery anomalies: An entity in search of an identity. Circulation, 115(10), 1296-305
Angelini, P., Villason, S., Chan, A.V., Diez, J.G. (1999) Normal and anomalous coronary arteries in humans. in: Angelini P; Fairchild V.D. [ed.] Coronary artery anomalies: A comprehensive approach, Philadelphia: Lippincott Williams & Wilkins, p. 27-79
Angelini, P., Flamm, S.D. (2007) Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults. Catheterization and Cardiovascular Interventions, 69(7): 942-954
Angelini, P., Velasco, J.A., Flamm, S. (2002) Coronary anomalies: Incidence, pathophysiology, and clinical relevance. Circulation, 105(20): 2449-54
Basso, C., Maron, B.J., Corrado, D., Thiene, G. (2000) Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. Journal of the American College of Cardiology, 35(6): 1493-1501
Chaitman, B.R., Lespérance, J., Saltiel, J., Bourassa, M.G. (1976) Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation, 53(1): 122-131
Chu, E., Cheitlin, M.D. (1993) Diagnostic considerations in patients with suspected coronary artery anomalies. American Heart Journal, 126(6): 1427-1438
Deibler, A.R., Kuzo, R.S., Vöhringer, M., Page, E. E., Safford, R.E., Patton, J. N., Lane, G.E., Morin, R.L., Gerber, T.C. (2004) Imaging of congenital coronary anomalies with multislice computed tomography. Mayo Clinic Proceedings, 79(8): 1017-1023
Drory, Y., Turetz, Y., Hiss, Y., Lev, B., Fisman, E.Z., Pines, A., Kramer, M.R. (1991) Sudden unexpected death in persons <40 years of age. American Journal of Cardiology, 68(13): 1388-1392
Eckart, R.E., Scoville, S.L., Campbell, C.L., Shry, E.A., Stajduhar, K.C., Potter, R.N., Pearse, L.A., Virmani, R. (2004) Sudden death in young adults: A 25-year review of autopsies in military recruits. Annals of Internal Medicine, 141(11): 829-34
Ghadri, J.R., Kazakauskaite, E., Braunschweig, S., Burger, I.A., Frank, M., Fiechter, M., Gebhard, C., Fuchs, T.A., Templin, C., Gaemperli, O., Lüscher, T.F., Schmied, C., Kaufmann, P.A. (2014) Congenital coronary anomalies detected by coronary computed tomography compared to invasive coronary angiography. BMC Cardiovascular Disorders, 14(1): 1-10
Hata, Y., Kinoshita, K., Kudo, K., Ikeda, N., Nishida, N. (2015) Anomalous origin of the right coronary artery from the left coronary sinus with an intramural course: Comparison between sudden-death and non-sudden-death cases. Cardiovascular Pathology, 24(3): 154-159
Ishikawa, T., Brandt, P.W.T. (1985) Anomalous origin of the left main coronary artery from the right anterior aortic sinus: Angiographic definition of anomalous course. American Journal of Cardiology, 55(6): 770-776
Kardos, A., Babai, L., Rudas, L., Gaál, T., Horváth, T., Tálosi, L., Tóth, K., Sárváry, L., Szász, K. (1997) Epidemiology of congenital coronary artery anomalies: A coronary arteriography study on a Central European population. Catheterization and Cardiovascular Diagnosis, 42(3): 270-275
Lipsett, J., Cohle, S.D., Berry, P.J., Russell, G., Byard, R.W. (1994) Anomalous coronary arteries: A multicenter pediatric autopsy study. Pediatric Pathology, 14(2): 287-300
Lipton, M.J., Barry, W.H., Obrez, I., Silverman, J.F., Wexler, L. (1979) Isolated single coronary artery: Diagnosis, angiographic classification, and clinical significance. Radiology, 130(1): 39-47
Maron, B.J., Doerer, J.J., Haas, T.S., Tierney, D.M., Mueller, F.O. (2009) Sudden deaths in young competitive athletes: Analysis of 1866 deaths in the United States, 1980-2006. Circulation, 119(8): 1085-1092
Ripley, D.P., Saha, A., Teis, A., Uddin, A., Bijsterveld, P., Kidambi, A., Mcdiarmid, A.K., Sivananthan, M., Plein, S., Pennell, D.J., Greenwood, J.P. (2014) The distribution and prognosis of anomalous coronary arteries identified by cardiovascular magnetic resonance: 15 year experience from two tertiary centres. Journal of Cardiovascular Magnetic Resonance, 16(1): 34-34
Roberts, W.C., Shirani, J. (1992) The four subtypes of anomalous origin of the left main coronary artery from the right aortic sinus (or from the right coronary artery). American Journal of Cardiology, 70(1): 119-121
Serota, H., Barth, C.W. 3rd, Seuc, C.A., Vandormael, M., Aguirre, F., Kern, M.J. (1990) Rapid identification of the course of anomalous coronary arteries in adults: The 'dot and eye' method. American Journal of Cardiology, 65(13): 891-898
Shirani, J., Roberts, W.C. (1993) Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies. Journal of the American College of Cardiology, 21(1): 137-143
Wang, A., Pulsipher, M.W., Jaggers, J., Peterson, G.E., O'Laughlin, M.P., Bashore, T.M., Harrison, J. K. (1997) Simultaneous biplane coronary and pulmonary arteriography: A novel technique for defining the course of an anomalous left main coronary artery originating from the right sinus of Valsalva. Catheterization and Cardiovascular Diagnosis, 42(1): 73-78
Yamanaka, O., Hobbs, R.E. (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Catheterization and Cardiovascular Diagnosis, 21(1): 28-40
Yildiz, A., Okcun, B., Peker, T., Arslan, C., Olcay, A., Bulent, V.M. (2010) Prevalence of coronary artery anomalies in 12,457 adult patients who underwent coronary angiography. Clinical Cardiology, 33(12): E60-E64
 

About

article language: English
document type: Case Report
DOI: 10.2298/VSP180314109B
published in SCIndeks: 15/06/2020
peer review method: double-blind
Creative Commons License 4.0