Single coronary artery with aortic regurgitation.
An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. Coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3+ aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively.
Katsetos
Manny C
MC
Cardiovascular Disease Fellowship Program, St. Francis Hospital and Medical Center, University of Connecticut School of Medicine, Hoffman Heart Institute, Hartford, Connecticut 06105, USA. mkatsetos@yahoo.com
Toce
Dale T
DT
D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography