CORONARY ANGIOPLASTY OF A SINGLE CORONARY-ARTERY WITH AN ANOMALOUS ORIGIN IN THE ASCENDING AORTA

Single coronary artery (SCA), defined as an artery that arises from an arterial trunk and nourishes the entire myocardium, is rare.(1) It oc curs either as an isolated anomaly(2) or, less commonly, in associatio n with other congenital anomalies.(3-6) In the latter cases, SCA may h ave an unusual site of origin, such as the inferior aspect of the aort ic arch,(3) right carotid artery,(4) right innominate artery,(5) or pu lmonary artery.(6) In contrast, when SCA is an isolated anomaly it ari ses from either the right or the left sinus of Valsalva,(2) with one r eported exception, in which the SCA had a high anterior take-off in th e ascending aorta.(7) Percutaneous transluminal coronary angioplasty ( PTCA) has been performed in patients with isolated SCA.(8-14) In these patients, the SCAs had their usual origins, either in the left(8) or in the right sinus of Valsalva.(9-14) Herein we report a PTCA procedur e performed in a patient with SCA, which had an unusual origin in the anterior aspect of the ascending aorta above the sino-tubular Line. A totally occluded lesion in the right coronary arterial branch of the S CA was successfully dilated.