Dual-guidewire percutaneous intervention of anomalous coronary artery facilitated by steerable guidewire.
Anomalous coronary arteries are rare and usually incidental angiographic findings. Their clinical importance lies in the potential risk for sudden cardiac death, especially if the course is interarterial (between the aorta and pulmonary artery). In these situations, coronary bypass surgery is the recommended treatment. When percutaneous interventions are undertaken, however, the nontraditional locations and frequently angulated ostia of these vessels can pose technical challenges. We hereby report a case of percutaneous intervention in an anomalous circumflex artery arising acutely from the right coronary ostium. Despite the use of an anchor wire in the patient's right coronary artery, access into the circumflex artery was possible only with a steerable guidewire. We believe that this is a potentially useful tool in percutaneous intervention of anomalous as well as other angulated coronary anatomies. The technical advantages of this wire, as well as a review of the literature on coronary anomalies and percutaneous interventions in these patients, are discussed.
Chen
Jack P
JP
Department of Cardiology, Saint Joseph's Hospital of Atlanta, 5670 Peachtree Dunwoody Road, #880, Atlanta, GA 30342, USA. chenjackapollo@yahoo.com
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents