Pop Marian, Pal Krisztina, Vaga Diana
Radiology Department, Tirgu Mures Emergency Institute for Cardiovascular Diseases and Heart Transplant, 540136 Tirgu Mures, Romania.
ME1 Department, "George Emil Palade", University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mures, 540142 Tirgu Mures, Romania.
Diagnostics (Basel). 2021 Jul 1;11(7):1199. doi: 10.3390/diagnostics11071199.
The prevalence of isolated right coronary artery (RCA) absence ranges from 0.014% to 0.066% in the general population, but its combination with an absent left main (dual ostium left anterior descending [LAD] and super-dominant left circumflex [LCx]) has not been previously described. We report the case of a rare coronary artery anomaly: an absent RCA with LAD and LCx coronary arteries arising separately from the left coronary sinus. A 53-year-old male with recent COVID-19 infection was referred to our service for coronary computed tomography angiography (CCTA) due to the recent onset of atypical chest pain. The RCA was absent, with no vessel leaving the right or non-coronary sinus. The LAD and LCx emerged from the left coronary sinus, with a "double-barrel" appearance. The LAD was unremarkable, with small, non-stenosed calcified plaque. The LCx had a 3 mm diameter, arching downward in the left atrioventricular groove, passing through the crux cordis, continuing into the right atrioventricular groove, and ending as a left acute artery and sinonodal artery. No significant stenosis was found on any of the vessels, ruling out atherosclerotic coronary disease.
孤立性右冠状动脉缺如在普通人群中的患病率为0.014%至0.066%，但其与左主干缺如（双开口左前降支[LAD]和超优势左旋支[LCx]）同时存在的情况此前尚未见报道。我们报告一例罕见的冠状动脉异常病例：右冠状动脉缺如，LAD和LCx冠状动脉分别发自左冠状动脉窦。一名近期感染新型冠状病毒肺炎的53岁男性因近期出现非典型胸痛被转诊至我院接受冠状动脉计算机断层扫描血管造影（CCTA）检查。右冠状动脉缺如，无血管发自右冠状动脉窦或无冠状动脉窦。LAD和LCx发自左冠状动脉窦，呈“双管”外观。LAD未见明显异常，有小的、无狭窄的钙化斑块。LCx直径为3 mm，在左房室沟向下走行，穿过心脏十字交叉，延续至右房室沟，最终成为左锐缘动脉和窦房结动脉。所有血管均未发现明显狭窄，排除了动脉粥样硬化性冠状动脉疾病。
