A Case of Congential Atresia of Left Main Coronary Ostium.
10.4070/kcj.1998.28.10.1794
- Author:
Hyung Wook PARK
;
Myung Ho JEONG
;
Young Keun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Jung Chaee KANG
- Publication Type:Case Report
- Keywords:
Congenital anomaly;
Left main coronary ostium;
Total occlusion
- MeSH:
Adult;
Arteries;
Chest Pain;
Constriction, Pathologic;
Coronary Artery Bypass;
Coronary Vessels;
Depression;
Dyspnea;
Exercise Test;
Female;
Follow-Up Studies;
Humans;
Mammary Arteries;
Perfusion;
Saphenous Vein;
Tomography, Emission-Computed, Single-Photon;
Transplants
- From:Korean Circulation Journal
1998;28(10):1794-1797
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Congenital atresia of left main coronary ostium is a rare congenital coronary anomaly. This anomaly was detected during elective coronary angiogram in a 40 year-old female patient with chest pain and exertional dyspnea. Treadmill exercise test demonstrated 2 mm upslope depression of ST segment at stage I and the test was terminated due to chest pain. Myocardial stress SPECT using 201 Tl-dipyridamole showed reversible perfusion defects at anterior, apex and lateral wall. It was impossible to select left coronary artery ostium and right coronary angiogram revealed 30% eccentric stenosis at proximal right coronary artery with grade 3 collateral flow to left anterior descending and circumflex arteries. Operative finding revealed totally occluded left coronary ostium with membrane-like, non-atheromatous tissue similar to aortic wall. The patient was successfully treated with coronary artery bypass grafts (CABG) using left internal mammary artery and great saphenous vein. She underwent follow-up coronary angiogram, which revealed patent grafts, at one year after CABG and no cardiovascular event was observed on 5-year clinical follow-up.
