Key result
Coronary artery bypass grafting successfully treated a 33-year-old male with a malignant anomalous left coronary artery, resulting in complete symptom resolution and restoration of physical activity at 2 years.
Why the study?
An anomalous left coronary artery arising from the right aortic sinus of Valsalva is rare and a leading cause of sudden cardiac death in young people, requiring prompt identification to mitigate early mortality risk.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
CABG with proximal ligation is a viable and durable surgical option for managing symptomatic anomalous left coronary artery arising from the right sinus of Valsalva in adults, leading to long-term symptom relief.
Background: Any variance of the normal coronary vasculature is regarded as a coronary artery anomaly (CAA). An atypical left coronary artery arising from the right aortic sinus of Valsalva has been identified as the rarest CAA and the second leading cause of sudden cardiac death (SCD) in young people. Prompt identification of the anomalous vessel is essential to mitigate early mortality risk. Case summary: A 33-year-old male, ex-smoker presented with exertional breathlessness and retrosternal chest tightness for the past 1 year. Past history also revealed a significant decline in his exercise tolerance. His initial work-up, which included a resting electrocardiogram and echocardiogram were within normal limits. His exercise tolerance test however, was discontinued early due to the onset of symptoms, and his exercise stress echocardiogram proved positive for angina at a low workload. The cardiac computed tomography angiography revealed a common origin for the left and right coronary systems from the right ostium, with the left main stem following an inter-arterial course and showing mild, diffuse narrowing. The patient was green-lit for coronary artery bypass grafting (CABG). Post recovery and almost 2 years on, he has remained symptom-free and has regained his physical activity. Conclusion: This case underlines the need for prompt identification and subsequent management of anomalous coronary arteries, given their association with SCD. Timely surgical intervention such as CABG can greatly mitigate the risk of grievous complications. The patient's complication-free postop recovery and resumption of physical activity, assures the reader that it is a viable and durable option with long-term quality of life improvement.
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Hossain et al. (2025) conducted a case report in Anomalous left coronary artery arising from the right aortic sinus of Valsalva (n=1). Coronary artery bypass grafting (CABG) was evaluated on Symptom resolution and physical activity restoration. Coronary artery bypass grafting successfully treated a 33-year-old male with a malignant anomalous left coronary artery, resulting in complete symptom resolution and restoration of physical activity at 2 years.
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