Wu Qiang, Li Zong-Zhuang, Yue Feng, Wei Fang, Zhang Chen-Yun
Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou Province, China.
World J Clin Cases. 2019 Aug 6;7(15):2128-2133. doi: 10.12998/wjcc.v7.i15.2128.
Single coronary artery (SCA) originating from a solitary ostium in the aorta and perfusing the entire myocardium is a very rare congenital anomaly of the coronary artery. Furthermore, a right coronary artery (RCA) arising from the mid segment of the left anterior descending artery (LAD) is an extremely uncommon variation of SCA.
A 76-year-old woman presented a 5-mo history of exertional angina. Selective coronary angiography revealed an SCA, with severe ostial stenosis that originated from the left sinus of Valsalva and bifurcated normally into the LAD and circumflex coronary artery. In addition, an anomalous RCA originated from the mid segment of the LAD as a separate branch. Successful balloon angioplasty and stenting for the SCA ostial stenosis were performed on the patient.
Percutaneous coronary intervention (PCI) of the main trunk for SCA is very similar to PCI of an unprotected left main coronary artery. Although technical difficulties and risks do exist, PCI for severe ostial stenosis of the main trunk is safe and efficacious in selected SCA patients.
单支冠状动脉（SCA）起源于主动脉的单个开口并灌注整个心肌，是一种非常罕见的冠状动脉先天性异常。此外，右冠状动脉（RCA）起源于左前降支动脉（LAD）的中段是SCA极其罕见的变异。
一名76岁女性有5个月劳力性心绞痛病史。选择性冠状动脉造影显示一支SCA，其开口严重狭窄，起源于主动脉左窦，正常分为LAD和左旋支冠状动脉。此外，一支异常的RCA作为一个单独分支起源于LAD的中段。对该患者成功进行了SCA开口狭窄的球囊血管成形术和支架置入术。
SCA主干的经皮冠状动脉介入治疗（PCI）与无保护左主干冠状动脉的PCI非常相似。虽然确实存在技术困难和风险，但对于选定的SCA患者，主干严重开口狭窄的PCI是安全有效的。
