Key result
Multimodality imaging and functional assessment refine single coronary artery evaluation beyond simple ostial classification.
Why the study?
Single coronary artery is a rare and anatomically heterogeneous congenital anomaly whose clinical significance depends on ostial and proximal morphology, coronary course, associated coronary disease, symptoms, and functional findings.
This review provides a structured three-domain framework (anatomy, functional findings, clinical-vascular context) for the multidisciplinary assessment of single coronary artery in adults.
Supports integrated multimodality assessment of single coronary artery anomalies; extends Lipton classification while leaving open prospective validation.
Background: Single coronary artery (SCA) is a rare and anatomically heterogeneous congenital coronary anomaly in which the entire coronary circulation arises from a single aortic ostium. Its clinical significance depends on the ostial and proximal morphology, coronary course, associated coronary disease, symptoms and, where indicated, functional findings. Methods: PubMed/MEDLINE was searched with free-text terms from 24 December 2025 to 12 July 2026 and rerun on 9 August 2026; relevant reference lists were screened manually. Results: SCA-specific evidence consisted mainly of case reports, small series, and descriptive imaging studies. A single ostium or Lipton code does not fully describe the relevant anatomy. Reports should state whether a true common trunk is present, map the course and supplied territory of each major branch, and document proximal morphology and acquired coronary disease. Coronary computed tomography angiography (CCTA) is central to anatomical assessment in many adults. Functional testing is most informative when the method addresses the suspected mechanism. Conclusions: SCA should be interpreted by integrating detailed anatomy, symptoms, coexisting coronary disease and, when appropriate, mechanism-matched functional findings. The three-domain structure used here supports reporting and multidisciplinary discussion, but it is not a validated risk model or treatment algorithm. Prospective evidence on SCA-specific outcomes and management remains limited.
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Muhtaroglu et al. (2026) conducted a review in Single Coronary Artery (SCA). Single Coronary Artery (SCA) was evaluated. Single coronary artery should be interpreted by integrating detailed anatomy, symptoms, coexisting coronary disease, and mechanism-matched functional findings rather than relying on a single ostium label.
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