A patient with a rare single coronary artery from the right coronary cusp was successfully treated for inferior STEMI with intravascular-guided PCI without complications.
This case demonstrates that while rare congenital single coronary artery anomalies introduce significant procedural challenges during emergency PCI for STEMI, successful revascularization can be achieved with intravascular guidance.
Absolute Event Rate: 0% vs 0%
Abstract Background Abnormal origin of a coronary artery is a rare congenital condition that can significantly affect clinical outcomes especially when associated with acute coronary syndromes. Among these, the presence of a single coronary artery trifurcating from the right coronary cusp into all major coronary branches is exceptionally rare and poorly represented in the literature. Case Summary A 35-year-old man presented with an inferior ST-elevation myocardial infarction. Emergency angiography revealed a single coronary artery arising from the right coronary cusp. The culprit was the right coronary artery. It was effectively treated with intravascular-guided percutaneous coronary intervention, and the remaining coronaries demonstrated normal flow, as shown in subsequent imaging. The patient recovered uneventfully, rehabilitated without complications. He was discharged on guideline directed medical therapy. Discussion Although the anomalous coronary anatomy was not the direct cause of infarction, it introduced significant procedural challenges that could have delayed or compromised revascularisation. Our case highlights the importance of recognising and anticipating coronary anomalies in acute settings. Multimodality imaging and anatomical classification systems help provide timely diagnosis, procedural planning, and risk assessment from a long-term perspective.
Bahlani et al. (Thu,) reported a other. A patient with a rare single coronary artery from the right coronary cusp was successfully treated for inferior STEMI with intravascular-guided PCI without complications.