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

Year 2019, Volume: 4 Issue: 1, 54 - 56, 15.03.2019

Yakup Alsancak , Sina Ali

https://doi.org/10.25000/acem.460782

Abstract

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.

Keywords

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

References

• 1- Yurtdas M, Gulen O. Anomalous origin of the right coronary artery from the left anterior descending artery: review of the literature. Cardiol J. 2012;19:122–9.
• 2- Alsancak Y, Sezenöz B, Duran M, Unlu S, Turkoglu S, Yalcın R. Acute Anterior Myocardial Infarction Accompanied by Acute Inferior Myocardial Infarction: A Very Rare Coronary Artery Anomaly. Case Rep Cardiol. 2015;2015:347126-3.
• 3- Desmet W, Vanhaecke J, Vrolix M, Van de Werf F, Piessens J, Willems J, et al. Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J. 1992;13:1637-40.
• 4- Turkmen S, Yolcu M, Sertcelik A, Ipek E, Dokumaci B, Batyraliev T. Single coronary artery incidence in 215,140 patients undergoing coronary angiography. Folia Morphol (Warsz). 2014;73:469-74.
• 5- Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990;21:28–40.
• 6- Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol. 1992;20:640–7.
• 7- Ogden JA, Goodyer AV. Patterns of distribution of the single coronary artery. Yale J Biol Med. 1970;43:11-21.
• 8- Alexander RW, Griggith GC. Anomalies of the coronary arteries and their clinical significance. Circulation. 1956;14:800-5.
• 9- Villa AD, Sammut E, Nair A, Rajani R, Bonamini R, Chiribiri A. Coronary artery anomalies overview: The normal and the abnormal. World J Radiol. 2016;8:537-55.
• 10- Ghadri JR, Kazakauskaite E, Braunschweig S, Burger IA, Frank M, Fiechter M, et al. Congenital coronary anomalies detected by coronary computed tomography compared to invasive coronary angiography. BMC Cardiovascular Disorders. 2014;14:1.
• 11- Wańha W, Roleder T, Kowalówka A, Wojakowski W. Acute coronary syndrome in a patient with an anomaly of the right coronary artery, which originated from the medial part of the left anterior descending artery. Kardiol Pol. 2015;73:375.
• 12- Mishra TK, Mishra CK, Das B. Percutaneous coronary intervention in a patient with single coronary artery. Indian Heart J. 2014;66:382-5.
• 13- Lanzieri M, Khabbaz K, Salomon RN, Kimmelstiel C. Pri¬mary angioplasty of an anomalous left main coronary artery: diagnostic and technical considerations. Catheter Cardiovasc Interv. 2003;58:185-8.
• 14- Lu R, Tang F, Zhang Y, Zhu X, Zhu S, Wang G, et al. Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis. J Am Heart Assoc. 2016;5:e003990.