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Case Reports
. 2019 Nov 7;3(4):1-4.
doi: 10.1093/ehjcr/ytz197. eCollection 2019 Dec.

Multivessel percutaneous coronary intervention with bifurcation stenting in a quadfurcated single coronary artery from the right aortic sinus: a case report

Mohammed Al Jarallah  1 , Rajesh Rajan  1 , Vladimir Kotevski  1 , Raja Dashti  1 , Wagdy Moustafa  2
Affiliations
Case Reports

Multivessel percutaneous coronary intervention with bifurcation stenting in a quadfurcated single coronary artery from the right aortic sinus: a case report

Mohammed Al Jarallah et al. Eur Heart J Case Rep. .

Abstract

Background: Quadfurcation of single coronary artery (SCA) from the right is an extremely rare anomaly and acute coronary syndrome in such patients is catastrophic.

Case summary: We report a 56-year-old Bangladeshi male who presented with an acute inferior wall ST-elevation myocardial infarction. He was taken to the Cath lab for primary percutaneous coronary intervention which showed the presence of SCA arising from the right aortic sinus with multiple lesions including a bifurcation lesion. Percutaneous coronary intervention was done successfully in two sessions.

Discussion: Tackling multiple lesions in a case of SCA with quadfurcation was challenging especially in the setting of SCA and bifurcation lesions. This is first reported case of this kind.

Keywords: Percutaneous coronary intervention; Case report; Quadfurcation; ST-elevation myocardial infarction; Single coronary artery; Trishul.

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Figures

Figure 1
Figure 1
Electrocardiogram diagnostic for inferior wall myocardial infarction.
Figure 2
Figure 2
Acute occlusion of proximal right coronary artery.
Figure 3
Figure 3
The final angiographic results with TIMI III flow and trident appearance.
Figure 4
Figure 4
Volume rending three-dimensional computed tomography coronary angiogram shows single coronary ostium arising from the right with three abnormal courses of coronary arteries and only right coronary artery was found to have a normal course. Left circumflex coronary artery was found to have retro-aortic course, left anterior descending artery had pre-pulmonic course, and first diagonal had a sub-pulmonic (septal) course.
None
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