Percutaneous Coronary Intervention and Complete Revascularization of a Patient with Cardiogenic Shock and an Anomalous Left Main Artery Arising from the Right Sinus of Valsalva

Claudiu Ungureanu*, Trine Hugues, Marc Blaimont, Jacques Auslender and Antoine de Meester

Department of Cardiology, Jolimont Hospital, Belgium

^*Correspondance to: Claudiu Ungureanu 

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Abstract:

Anomalous origin of the Left Main Coronary Artery (LM) from the right sinus of Valsalva is a very rare congenital anomaly. We report a 67-year-old female presented with Acute Coronary Syndrome (ACS) and cardiogenic shock. The coronary angiogram showed the LM originating from the right coronary sinus, with a thrombotic lesion in the ostium of the circumflex artery and a chronic total occlusion of the Left Anterior Descending artery (LAD) and the Posterior Descending artery (PD). After percutaneous implantation of a circulatory support with Extracorporeal Membrane Oxygenation (ECMO) the patient was fully revascularized. The procedure was very difficult regarding the complex coronary anatomy and the presence of two chronic occlusion but the clinical evolution was favorable. This case highlights the benefits of complete revascularization in this particular situation and the importance of an appropriate circulatory support.

Keywords:

Anomalous coronary artery; Congenital coronary artery; Cardiogenic shock; Chronic total occlusion

Cite the Article:

Ungureanu C, Hugues T, Blaimont M, Auslender J, de Meester A. Percutaneous Coronary Intervention and Complete Revascularization of a Patient with Cardiogenic Shock and an Anomalous Left Main Artery Arising from the Right Sinus of Valsalva. Ann Clin Case Rep. 2020; 5: 1820.