PMC4683792_01
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-AP view fluoroscopy shows blunt left sinus (arrow) with no coronary origin.
JCIS-5-65-g002.jpg
PMC4683792_01_JCIS-5-65-g002.jpg
F1
Corp., Kanagawa, Japan) was performed. CAG revealed blunt left sinus, with no artery originating from the left sinus [Figure 1 and Video 1].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-AP view fluoroscopy shows blunt left sinus with no coronary origin.
JCIS-5-65-g003.jpg
PMC4683792_01_JCIS-5-65-g003.jpg
F2
Right coronary artery originated from the usual location and a long left main coronary artery arose from the same ostium [Figures 2, 3 and Video 2]. Tiger catheter with Judkin's right coronary catheter (Medtronic, Inc., Minneapolis, MN, USA) as it was not possible to selectively cannulate the ostium with the Tiger catheter. There was significant tubular stenosis in the mid-RCA region and non-critical plaque in the proximal left coronary artery (LCA) [Figures 2, 3 and Videos 2, 3].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-right anterior oblique angiographic view shows both right and left coronaries originating from the right sinus (arrow).
JCIS-5-65-g004.jpg
PMC4683792_01_JCIS-5-65-g004.jpg
F3
Right coronary artery originated from the usual location and a long left main coronary artery arose from the same ostium [Figures 2, 3 and Video 2]. Tiger catheter with Judkin's right coronary catheter (Medtronic, Inc., Minneapolis, MN, USA) as it was not possible to selectively cannulate the ostium with the Tiger catheter. There was significant tubular stenosis in the mid-RCA region and non-critical plaque in the proximal left coronary artery (LCA) [Figures 2, 3 and Videos 2, 3].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-lateral angiographic view shows both RCA and LCA originating from same ostium (arrow).
JCIS-5-65-g005.jpg
PMC4683792_01_JCIS-5-65-g005.jpg
F4
As it is important to know the course of anomalous coronaries before any intervention, CT angiogram was done which revealed retroaortic course of the left coronary [Figures 4 and 5]. The lesion was crossed with 0.014'' x 190 cm BMW wire (Abbott Vascular, Santa Clara, CA, USA) and predilated with 2.5 x 12 mm Maverick balloon (Boston Scientific, Florida, USA) [Figure 6 and Video 4].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-right anterior oblique angiographic view shows both right and left coronaries originating from the right sinus.
JCIS-5-65-g006.jpg
PMC4683792_01_JCIS-5-65-g006.jpg
F5
As it is important to know the course of anomalous coronaries before any intervention, CT angiogram was done which revealed retroaortic course of the left coronary [Figures 4 and 5]. A 3.25 x 33 mm Xience V stent (Abbott Vascular, Florida, USA) was deployed at 14 atm [Figure 7 and Video 5].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. Coronary angiography-lateral angiographic view shows both RCA and LCA originating from same ostium.
JCIS-5-65-g007.jpg
PMC4683792_01_JCIS-5-65-g007.jpg
F6
The lesion was crossed with 0.014'' x 190 cm BMW wire (Abbott Vascular, Santa Clara, CA, USA) and predilated with 2.5 x 12 mm Maverick balloon (Boston Scientific, Florida, USA) [Figure 6 and Video 4]. There were no complications [Figure 8 and Video 6].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. CT coronary angiography-CT image with 3D reconstruction shows retroaortic course of LCA (arrow).
JCIS-5-65-g008.jpg
PMC4683792_01_JCIS-5-65-g008.jpg
F7
A 3.25 x 33 mm Xience V stent (Abbott Vascular, Florida, USA) was deployed at 14 atm [Figure 7 and Video 5].
60-year-old male with ACS-inferior wall MI, post thrombolysis and post MI angina. CT coronary angiography-CT axial image shows all three coronary arteries.
JCIS-5-65-g009.jpg
PMC4683792_01_JCIS-5-65-g009.jpg
F8
There were no complications [Figure 8 and Video 6].