Zaveri Sahil, Schrem Ezra, Aykent Kazim, McFarlane Samy I, Gandotra Puneet, Budzikowski Adam S
Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University, New York, USA.
Cardiovascular Research Program, Veterans Affairs (VA) New York Harbor Healthcare System, New York, USA.
Cureus. 2024 Apr 30;16(4):e59378. doi: 10.7759/cureus.59378. eCollection 2024 Apr.
Coronary artery anomalies present unique interventional challenges, particularly when associated with significant coronary artery disease. This case report contributes to the limited literature on congenital coronary artery anomalies, emphasizing the need for tailored approaches to optimize patient care. We present a case of a 70-year-old male with refractory angina and a rare congenital coronary anomaly characterized by the absence of the right coronary artery ostium, necessitating reliance on the left coronary system for myocardial perfusion. Cardiac catheterization revealed mid-left anterior descending artery stenosis, prompting percutaneous coronary intervention. Despite the anatomical complexities encountered, the procedure was successfully performed. This case underscores the importance of meticulous diagnostic evaluation, advanced imaging techniques, and a multidisciplinary approach to managing patients with rare coronary anomalies. This report also emphasizes the unique diagnostic and therapeutic considerations by providing a comprehensive literature review and identifying areas for further research to advance treatment strategies and improve outcomes.
冠状动脉异常带来了独特的介入挑战，尤其是当与严重冠状动脉疾病相关时。本病例报告为关于先天性冠状动脉异常的有限文献增添了内容，强调了采用量身定制的方法以优化患者护理的必要性。我们报告一例70岁男性患者，患有难治性心绞痛，且存在一种罕见的先天性冠状动脉异常，其特征为右冠状动脉开口缺失，心肌灌注需依赖左冠状动脉系统。心脏导管检查显示左前降支中段狭窄，促使进行经皮冠状动脉介入治疗。尽管遇到了解剖结构复杂的情况，但该手术仍成功完成。本病例强调了细致的诊断评估、先进的成像技术以及多学科方法在管理罕见冠状动脉异常患者中的重要性。本报告还通过提供全面的文献综述并确定进一步研究的领域以推进治疗策略和改善治疗结果，强调了独特的诊断和治疗考量。
