Emergency angioplasty and stent deployment for acute occlusion of an anomalous single coronary artery - (All three coronary arteries from one ostium in the right sinus of Valsalva)

A single coronary ostium is traditionally considered to be of little clinic al significance. We report a case of a single ostium in the right sinus of Valsalva, giving rise to the right coronary artery, from which the left mai n coronary artery originated. Sudden death occurred seven days after acute gastrointestinal bleeding and subsequent interruption of aspirin therapy. A cute coronary angiography following successful resuscitation revealed an as cending thrombus in the right coronary artery. The patient underwent a comp lex percutaneous coronary angioplasty with stent deployment. We conclude th at coronary artery disease may lead to severe ischemia with a large area at risk and major complications in patients with coronary anomalies. Patients with acute stent implantation might benefit from platelet aggregation even in cases of recent intestinal bleeding.