Anomalous Origin of Left Main Coronary Artery from the Right Sinus of Valsalva: A Case Series-Based Review

Abstract

Established Facts: \n \n \n Anomalies of origin of Coronary arteries is an incidental finding occurring in 0.24 to 1.3% of the patients under doing angiography. \n The great majority of such anomalies are benign (anatomic variants of normal, with normal function). \n Most common coronary anomaly is Left circumflex artery (LCX) originating from Right sinus of Valsalva (RSV), followed by a single coronary artery from left sinus of Valsalva. \n Anomalous origin of Left Main Coronary Artery (LMCA) from Right sinus of Valsalva with an intramural course carries highest risk for sudden cardiac death and usually requires surgical intervention. \n \n \n\xa0 \n \nNovel Insights: \n \n \n Management of patients with coronary artery anomalies involving left main should be irrespective of ischemic symptoms or documented myocardial ischemia. \n In coronary angiograms performed on symptomatic patients with coronary artery anomalies, the degree of stenosis does not typically correlate with the clinical presentation. \n Due to lack of data and inability to predict sudden cardiac death, we agree with the latest AHA/ACC guidelines which recommend surgical intervention for all patients with LMCA from RSV, regardless of ischemia or ischemic symptoms. \n If a malignant or intramural course is discovered incidentally, surgery should be planned to prevent sudden cardiac death in such patients.