Congenital single coronary artery: A rare anatomic variant

摘要

Isolated congenital single coronary artery (SCA) is rare (incidence 0.024-0.066%). We present a case of a Lipton -1 subtype single coronary artery, incidentally discovered on coronary angiography prior to mitral valve surgery. A 70 y/o male presented to the cardiac catheterization laboratory for angiography prior to valve surgery. The left main coronary artery divided into the left anterior descending (LAD) artery and circumflex (LCx). The right coronary artery (RCA) arose as an extension of the LCx, tracing the atrio-ventricular groove before terminating at the anterior base. A separate RCA ostium was absent on aortography. Isolated congenital single coronary artery (SCA) is rare (incidence 0.024-0.066%) [1]. In the three group Lipton scheme, SCA group 1 is characterized by the absent artery arising from the distal end of the native artery. This patient would be considered an L-l subtype. An R-l variant would have the right coronary artery supplying the left system. Group 2 SCAs arise from the proximal native artery and cross at the cardiac base. In group 3, the LAD and LCx are two separate vessels originating from the proximal RCA [2].