Aortography showed that the coronary trunk was originating from the ascending aorta (Figure 1(a)). He underwent coronary angiography via the transradial approach to estimate cardiac ischemia.Ĭoronary angiography showed no vessel arising from each coronary sinus. Echocardiography showed normal function and normal chamber size.

An electrocardiogram obtained at rest showed sinus rhythm and no significant ST-T change. His serum creatinine level was 1.22 mg/dL and estimated glomerular filtration rate was 47 mL/min/1.73 m 2. The patient’s coronary risk factors included hypertension and dyslipidemia. CaseĪ 65-year-old male patient was admitted to our hospital complaining of chest oppression during light exertion. We report a rare case with a single coronary trunk of anomalous origin that was successfully treated using the GuideLiner catheter (Vascular Solutions, MN, USA). This patient’s unusual anatomy led to several problems, including selection of the guide catheter, insufficient backup force, and difficulties of stent delivery in percutaneous coronary intervention (PCI). We experienced an extremely rare case involving a single coronary trunk arising anomalously from the ascending aorta. In addition, a single coronary trunk is also rare, with an incidence of 0.12%. Coronary artery anomalies of anomalous origin are uncommon but are occasionally encountered in clinical practice, with an incidence of 0.3–5%. IntroductionĬoronary artery anomalies are a diverse group of congenital disorders with many variations. We successfully performed revascularization by using the GuideLiner catheter.

We report a case of angina having a lesion in the left anterior descending artery of a single coronary trunk arising from the ascending aorta. The GuideLiner catheter, which is a coaxial guide extension having the advantage of rapid exchange, facilitates coronary intervention for complex lesions. In percutaneous coronary intervention for the lesion of a coronary artery anomaly, several problems may occur, including selection of a guide catheter, insufficient backup force, and difficulties of stent delivery. Cases in which an anomalous single coronary trunk arises from the ascending aorta are extremely rare.

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