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World J Cardiol. 2011 Sep 26;3(9):311-4. doi: 10.4330/wjc.v3.i9.311.

Percutaneous revascularization in a patient with anomalous origin of left main coronary artery.

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  • 1Rajesh Vijayvergiya, Anil Grover, Department of Cardiology, Advance Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.

Abstract

Anomalous origin of the coronary artery from opposite coronary sinus is infrequently observed during coronary angiography. Percutaneous coronary intervention (PCI) of anomalous coronary artery is technically difficult and challenging. It requires appropriate selection of guide catheters for adequate stability, coaxial alignment and backup support during the intervention. We hereby report a rare case of anomalous origin of left main coronary artery (LM) from the right coronary sinus, having a retro-aortic course to the left side before its bifurcation into left anterior descending (LAD) and circumflex artery. The 59-year-old man had successful PCI of atherosclerotic LAD lesions. A 64-slice Multi-Detector Computed Tomography (MDCT) performed at 4 years of follow-up demonstrated patency of coronary stents and also delineated the origin and course of the anomalous LM. The case illustrates the rarity of anomalous LM, and describes technical issues during PCI and the role of MDCT in coronary anomaly imaging.

KEYWORDS:

Anomalous left main coronary artery; Atherosclerosis; Coronary artery anomalies; Drug-eluting stent; Multi-detector computed tomography; Percutaneous coronary intervention; Retro-aortic course

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