Cardiovasc Imaging Asia.  2023 Oct;7(4):49-51. 10.22468/cvia.2023.00080.

Conquering Chaos in ACAOS: Primary Angioplasty in an Anomalous Right Coronary Artery Arising From the Opposite Coronary Sinus

• Veeraraghavan S
• Kidambi BR
• Munisingh A

• KMID: 2551119
• DOI: http://doi.org/10.22468/cvia.2023.00080

Abstract

A 55-year-old female patient with acute inferior wall ST-elevation myocardial infarction underwent primary angioplasty. A coronary angiogram revealed a proximally occluded but anomalous right coronary artery (RCA) arising from the opposite coronary sinus, i.e., the left sinus of Valsalva. During angioplasty, difficulty in tracking the stent due to a slit-like ostium and acute angulation of RCA on the angiographic images was noted, and the procedure was completed with the help of guide extension. Later, a computed tomography coronary angiogram revealed the interarterial course of the RCA with patent stents.

Keyword

Coronary anomaly; Primary angioplasty; Anomalous origin of the right coronary artery from the opposite sinus; Interarterial course; Sudden cardiac death