Single coronary artery anomaly: a report of three cases.

We presented three cases of anomalous single coronary artery detected incidentally during routine coronary angiography. The presenting symptoms were chest pain, angina pectoris, and exertional chest pain, respectively. In one case (male, 69 years), the single coronary artery gave off branches to the left anterior descending artery, left circumflex (LCx) artery, and right coronary artery (RCA) (type L-I). There were no atherosclerotic lesions. The patient's chest pain was thought to have a noncardiac origin and it did not recur during a 12-month follow-up. In another case (male, 65 years), the single coronary artery originated from the right sinus of Valsalva, and gave off branches to the RCA and the left coronary system (type R-I). The patient underwent coronary artery bypass surgery for significant stenotic lesions in the LCx and RCA. He was free of angina pectoris within 12 months after surgery. In the third case (female, 48 years), a single coronary ostium gave branches to the right and left coronary systems (type R-II-B). As the course of the coronary artery was between the aorta and pulmonary artery, surgery was recommended, but the patient refused surgery.