Sol ön inen koroner arterden kaynaklanan sağ koroner arter: Tek koroner arter anomalisinin farklı bir tipi

Öz

Benign bir durum olarak kabul edilmelerine rağmen, koroner arter anomalilerinin klinik görünümü göğüs ağrısı, nefes darlığı, çarpıntı, malign aritmiler, miyokard enfarktüsü, senkop ve ani ölüm gibi geniş bir spektruma sahiptir. Sağ koroner arterin sol ön inen koroner arterden köken aldığı tek koroner arterin atipik formu son derece nadir bir koroner anomalidir.

Bu yazıda, tekrarlayan göğüs ağrısı ve akut koroner sendrom nedeniyle koroner anjiyografiye alınan 63 yaşında bir kadın olgu sunuldu. Koroner anjiyografide, sağ koroner arterin sol ön inen koroner arterden köken aldığı atipik bir tek koroner arter anomalisi saptandı. Tedavi stratejisi kalp takımı ve hasta ile tartışıldı. Tekrarlayan göğüs ağrısı, izole sol ön inen koroner arter lezyonu ve hastanın tercihi nedeniyle perkütan koroner girişim (PKG) yapıldı.

Sonuç olarak, bu olgu, tek koroner arter anomalisi olan hastalarda PKG'in uygulanabilirliğini göstermesi bakımından önemlidir.

Anahtar Kelimeler

• Anomali,perkütan girişim,tek koroner arter

The right coronary artery originating from the left anterior descending artery: A variant of single coronary artery anomaly

Abstract

Although coronary artery anomalies have been accepted as benign conditions, clinical presentations have a large spectrum including chest pain, dyspnea, palpitations, malign arrhythmias, myocardial infarction,  syncope and sudden death. An atypical anomalous form of single coronary artery in which the right coronary artery originates from the left anterior descending coronary artery is an extremely rare situaiton.

In this report,  we presented a case of 63 years old woman who was taken to the coronary angiography due to recurrent chest pain and acute coronary syndrome. Coronary angiography revealed an atypical form of single coronary artery anomaly that the right coronary artery originates from the left anterior descending coronary artery. The treatment strategy was discussed with heart team and patient.  Percutaneous coronary intervention (PCI) was performed because of her recurrent chest pain and isolated LAD lesion and preference of the patient. 

In conclusion, this case is important for demonstrating the feasibility of PCI in patients with single coronary artery anomaly.

Keywords

• Anomaly,percutaneous intervention,single coronary artery

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