Author + information
- Received January 29, 2014
- Accepted February 13, 2014
- Published online October 1, 2014.
- ∗Division of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, Kansas
- †Division of Cardiovascular Diseases, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri
- ↵∗Reprint requests and correspondence:
Dr. Suresh Sharma, Mount Sinai Hospital, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, New York 10029.
A 57-year-old man presented with chest pain suggestive of obstructive coronary artery disease. Coronary angiography revealed a rudimentary left main coronary artery arising from the left sinus of Valsalva. A large right coronary artery was visualized arising from the right sinus of Valsalva and continuing as the posterior descending artery and wrapping around the apex to continue in the anterior interventricular groove, analogous to the anatomic left anterior descending artery, with further continuation in the left atrioventricular groove as the left circumflex artery (Figure 1, Online Video 1). Coronary computed tomography angiography (Figures 2A and 2B) confirmed the presence of a solitary coronary artery.
A solitary coronary artery is a rare coronary anomaly, with an incidence estimated at 0.02% to 0.03%. Numerous variations of the solitary coronary artery have been described based on Lipton’s classification (1). Of these, a single coronary artery arising from the right sinus of Valsalva is exceedingly rare. The prognosis of individuals with a solitary coronary artery remains unclear because of a paucity of published reports, and revascularization is considered if there is significant atherosclerosis and documented ischemia.
For the supplemental video, please see the online version of this article.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 29, 2014.
- Accepted February 13, 2014.
- American College of Cardiology Foundation