A Novel Technique for Percutaneous Coronary Intervention for Anomalous Right Coronary Artery Arising from the Left Sinus of Valsalva.
BACKGROUND
Percutaneous coronary intervention (PCI) for anomalous right coronary artery (RCA) arising from the left sinus of Valsalva (LSOV) is a technical challenge due to inadequate guiding catheter support to overcome the acute rightward course of the anomalous RCA. In this study we describe a novel technique for PCI for an anomalous RCA arising from the LSOV.


METHODS
Six patient cases with anomalous RCA arising from the LSOV who underwent PCI from January 2001 to January 2014. The Judkins left (JL) guiding catheter tip orientation is modified by manually bending at the distal tip 90° vertically to fit the acute rightward course.


RESULTS
Of the six patients (mean age: 63 ± 16.7 years), the indication for PCI was acute inferior myocardial infarction (MI) in two, recent inferior MI in two, and angina in two of the cases. Three procedures were performed via a transfemoral approach and the other three via a transradial approach. The median duration of the intervention and total procedure time were 44 and 69.5 minutes, respectively. All patients received successful revascularization without complications.


CONCLUSIONS
This novel technique is simple, safe and effective with a 100% procedure success rate for PCI for anomalous RCA arising from the LSOV.


BACKGROUND
Anomalous right coronary artery; Left sinus of Valsalva; Percutaneous coronary intervention.
Division of Cardiology, Far-Eastern Memorial Hospital;
Chun-Chung
CC
Lin
Division of Cardiology, Taipei Tzu Chi Hospital, School of Medicine, Tzu Chi University, New Taipei City, Taiwan.
Kuan-Hung
KH
Yeh
Division of Cardiology, Taipei Tzu Chi Hospital, School of Medicine, Tzu Chi University, New Taipei City, Taiwan.
Hsin-Hua
HH
Chou
Division of Cardiology, Taipei Tzu Chi Hospital, School of Medicine, Tzu Chi University, New Taipei City, Taiwan.
Shun-Yi
SY
Hsu
Division of Cardiology, Taipei Tzu Chi Hospital, School of Medicine, Tzu Chi University, New Taipei City, Taiwan.
Heng-Chia
HC
Chang