• Journal of Chest Surgery
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• v.15 no.3
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• pp.366-369
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• 1982

Single coronary artery is rare congenital anomaly with incidence about 0.04%. Above half of single coronary artery is symptomless, and about 41% of cases are associated with another congenital cardiac anomalies . Single coronary artery is sometimes important for cardiac operation to avoid fatal result from cutting of coronary artery during the right ventriculotomy. Among the associated anomaly of the single coronary artery, coronary arteriovenous fistula is very rare. We experienced congenital single coronary artery with coronary arteriovenous fistula drained into the right ventricle, and so we report this case with literatures.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.251-253
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• 1996

In the surgical repair of tetralogy of Fallot, the anomalous origin of the coronary artery has significant surgical implication. The coronary anomalies of concern are origin of the anterior descending coronary artery from the right coronary artery and certain variations of single coronary branching. We experienced a case of tetralogy of Falloff with single coronary artery from the left coronary sinus, from which the right coronary artery originated crossing the right ventricular outflow tract. This ty e of coronary anomaly in tetralogy of Fallot is known to be extremly rare.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.37-40
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• 2015

The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular followup.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1036-1041
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• 1994

Emergency operation was performed in a patient with severe aortic insufficiency caused by type A acute aortic dissection with aberrant high take-off origin of single coronary artery. The single coronary artery was found to arise from an unusual position high in the ascending aorta. Dissection was begun in the aortic root and involved the single coronary ostium. Valve competance was restored by resuspension of the commissures. the false lumen was obliterated with strips of Teflon felt and surgical glue. The aortic tissues were firmly reinforced and sutured. The proximal aortic stump was anatomically reconstructed, and fortunately the aortic valve was preserved and coronary reimplantation avoided. The patient was discharged at postoperative 13 days without specific complications. Postoperative course during the 18 months follow-up was uneventful.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.842-849
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• 1988

Between July, 1987, and September, 1988, 6 patients with coronary occlusive disease received coronary artery bypass surgery at Kyungpook University Hospital. There were five males and one female whose age ranged from 39 to 64 years[mean 54*8.0 years]. Of the 6 patients, 5 suffered from unstable angina, 1 suffered from stable angina. Selective coronary angiography revealed a significant stenosis of the left anterior descending artery in 6 cases, of its diagonal branch in 1 case, of the right coronary artery in 1 case, the circumflex artery in 1 case, and of its obtuse marginal branch in 1 case. The mode of anastomosis were single saphenous vein graft in 3 cases, single left internal mammary artery graft in 1 case, double saphenous vein graft with sequential anastomosis in 1 case, and left internal mammary artery plus saphenous vein graft in 1 case. Of these, 6 grafts to left anterior descending artery were done. There was no operative death, but perioperative myocardial infarction was happened in 1 case. All survivors were free of angina and discontinuing medical therapy during the follow up period[mean 7.8*5.15 months].

• Journal of Chest Surgery
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• v.20 no.4
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• pp.793-797
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• 1987

Coronary artery fistula is an uncommon congenital heart defect that is readily amenable to surgical treatment. This fistula usually originates from the right coronary artery, but may arise from the left coronary artery, both coronary arteries, or single coronary artery. And the fistulous communication is most often to right ventricle, right atrium or pulmonary artery. Recently we experienced one case of congenital coronary artery fistula which was associated with patent ductus arteriosus. The fistulous communication, forming aneurysmal dilatation, was noted between the left anterior descending coronary artery and the right ventricular outflow tract. Cardiopulmonary bypass was employed in this case. After an arteriotomy was made on the aneurysmal coronary artery, both the proximal opening and the termination site of the fistulous tract were directly closed with partial aneurysmorrhaphy. The right ventricular chamber was also opened to evaluate the fistulous termination site. Postoperative hospital course of the patient was uneventful and she was discharged without problems.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.472-476
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• 1994

The incidence of single coronary artery is extremely rare in a review of congenital anomalies of the coronary arteries. This 27-year-old male patient was referred for the evaluation of cardiac condition showing exertional dyspnea[NYHA class II-III] and chest discomfort for about 1 year. A complete catheterization study including angiogram disclosed large single coronary artery arising from left aortic sinus [Ogden classification L-4] associated with bicuspid aortic valvular stenosis and low grade supravalvular aortic stenosis. Calcified stenotic aortic valve was fully removed with caution and the 19mm St. Jude Medical valve was then implanted in the small nortic annulus. The patient had an uneventful recovery and was discharged on 13th postoperative day.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1118-1122
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• 2008

A case of a single coronary artery complicated with a coronary artery fistula (CAF) to the right ventricle is extremely rare, and its management strategy and prognosis are not clear. A 5-year-old boy was hospitalized for evaluation of a continuous heart murmur. Transthoracic echocardiography suggested a CAF to the right ventricle, with an enlarged left coronary artery. Cardiac catheterization confirmed the CAF terminating at the right ventricle and the absence of a right coronary artery. The fistula was ligated at the right ventricular side under cardiopulmonary bypass. At follow-up 18 months later, the child was clinically asymptomatic, and coronary angiogram showed no recurrence of the fistula.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.384-392
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• 1989

Forty cases of coronary artery bypass grafting treated at the Department of Thoracic and Cardiovascular Surgery, SNUH, Korea were compared with forty cases of the procedure treated at University of Alberta Hospital, Canada, in terms of pathoanatomy. That showed no difference in sex ratio between Korean and Caucasian the average ages, however, were 50.4 years and 60.9 years respectively [p< 0.005]. The leading cause of angina at presentation was unstable angina in Korean, but it was post-infarction angina in Caucasian instead. The incidences of single-vessel disease and double-vessel disease were similar in both countries, but the incidence of so-called triple-vessel disease was higher in Caucasian while left main coronary artery disease was more prevalent in Korean [0.01< P, 0.005]. < The internal diameters of surgically available coronary artery branches had similar characteristics and no significant statistical differences were found between them. The predilection sites of stenoses were proximal left anterior descending artery, left main coronary artery, proximal left circumflex artery and proximal right coronary artery decreasing in incidence respectively, in Korean. The myocardial perfusion score were 6.80 in single-vessel disease, 7.56 in double-vessel disease, 11.27 in triple-vessel disease and 9.77 in left main disease respectively, in Korean.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.373-378
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• 1988

Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.