Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Aug 27:8:699529.
doi: 10.3389/fcvm.2021.699529. eCollection 2021.

Case Report: Congenital Coronary Artery Ring With Single Left Coronary Ostium and Fistula: A Previously Unreported Anatomy

Shiyuan Tang  1 , Mi Tang  1 , Chukwuemeka Daniel Iroegbu  1 , Jinfu Yang  1 , Chengming Fan  1
Affiliations
Case Reports

Case Report: Congenital Coronary Artery Ring With Single Left Coronary Ostium and Fistula: A Previously Unreported Anatomy

Shiyuan Tang et al. Front Cardiovasc Med. .

Abstract

Background: Single coronary ostium concomitant with coronary artery fistula is a very rare congenital anomaly. Apart from that, the combination of a closed loop of the coronary artery has never been reported. Case presentation: Herein, we present a 7-year-old girl diagnosed as single left coronary ostium with a giant coronary trunk, coronary artery to right ventricle fistula, and coronary artery ring. The coronary fistula was surgically ligated with off-pump strategy and the patient discharged on postoperative day 5 and free of symptoms during the 3 years of follow-up. Conclusion: To our knowledge, the presented congenital coronary anomaly is the first to be reported in the literature with the name of congenital coronary artery ring with single left coronary ostium and fistula.

Keywords: coronary artery anomalies; coronary artery fistula; coronary artery ring; giant coronary trunk; single coronary ostium.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Computed tomography angiography preoperatively showing that there is an interruption between right sinus of Valsalva and the enlarged and tortuous right main coronary artery (A, arrow), a single left coronary ostium with a giant coronary trunk (B, arrow), a 7-mm fistula into the right ventricle (Red) (C, arrow), the left and right coronary artery were connected with each other and formed a closed loop at the base of the heart (D).
Figure 2
Figure 2
Ascending aortic angiography preoperatively showing that the left and right coronary artery were enlarged and tortuous (A), right coronary artery was detected secondly to the left one (B), confirming the diagnosis of coronary artery ring with single left coronary ostium and fistula.
Figure 3
Figure 3
Intraoperative view showing that the fistula was ligated with off-pump strategy.
Figure 4
Figure 4
Transthoracic echocardiography showing that a 6.28-mm coronary fistula into the right ventricle (A, arrow) was detected preoperatively, and undetectable 1 week post-surgical ligation (B).
See this image and copyright information in PMC

References

    1. Desmet W, Vanhaecke J, Vrolix M, Van de Werf F, Piessens J, Willems J, et al. . Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J. (1992) 13:1637–40. 10.1093/oxfordjournals.eurheartj.a060117 - DOI - PubMed
    1. Ishii Y, Suzuki T, Kobayashi T, Arakawa H. Single coronary artery with right ventricular fistula: case report and literature review. Congenit Heart Dis. (2010) 5:56–9. 10.1111/j.1747-0803.2009.00308.x - DOI - PubMed
    1. Soon KH, Selvanayagam J, Bell KW, Tang SH, Pereira J, Chan W, et al. . Giant single coronary system with coronary cameral fistula diagnosed on MSCT. Int J Cardiol. (2006) 106:276–8. 10.1016/j.ijcard.2004.12.093 - DOI - PubMed
    1. Uechi Y, Higa K. Single left coronary artery with microfistula communicating with the left ventricle: a case report. J Cardiol. (2007) 50:199–203. - PubMed
    1. Xie LJ, Zhang L, Xiao TT, Shen J. Coronary artery fistula between single right coronary artery and right pulmonary artery: a case report and literature review. BMC Cardiovasc Disord. (2015) 15:171. 10.1186/s12872-015-0166-2 - DOI - PMC - PubMed

Publication types

LinkOut - more resources