Severe stenosis of left coronary artery originating from right sinus of Valsalva treated with off-pump coronary artery bypass surgery.
Anomalous origin of the left coronary artery originating from the opposite sinus of Valsalva is a coronary anomaly with a consistently low prevalence rate. Different patterns have been described for this type of anomaly with respect to the position and course of the coronary arteries. The interarterial type can be considered a malignant variant, as it is characterized by a left main coronary artery that is positioned between the aortic root and the pulmonary artery root, and it frequently presents with syncope or aborted sudden cardiac death. Other symptoms or clinical presentations include the presence or development of angina, acute myocardial infarction and ventricular tachycardia. We present the case of a 49-year old man who presented with a new onset of chest pain; a coronary angiogram showed an anomalous left main coronary artery arising from the right Valsalva sinus, accompanied by a long and severe stenosis. It was found that multi-scan cardiac tomography is very useful in identifying the position of the coronary arteries when coronary anomalies occur.
Department of Cardiovascular Science, Cardiovascular Surgery Unit, University Campus Bio-Medico of Rome, Rome, Italy f.prestipino@unicampus.it filippo.prestipino@libero.it.
Filippo
F
Prestipino
Department of Cardiovascular Science, Cardiovascular Surgery Unit, University Campus Bio-Medico of Rome, Rome, Italy.
Mario
M
Lusini
Department of Cardiovascular Science, Cardiovascular Surgery Unit, University Campus Bio-Medico of Rome, Rome, Italy.
Cristiano
C
Spadaccio
Department of Cardiovascular Science, Cardiovascular Surgery Unit, University Campus Bio-Medico of Rome, Rome, Italy.
Massimo
M
Chello
D017023:Coronary Angiography / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014654:Vascular Patency
Cardiac tomography; Coronary angiography; Coronary anomalous origin; Coronary anomaly; Coronary bypass