Primary Percutaneous Coronary Intervention Angioplasty of Occluded Twin Circumflex Coronary Artery in a Patient of Acute Inferior Wall Myocardial Infarction: A Rare Anomaly

Santosh Kumar Sinha, Vikas Mishra, Nasar Abdali, Mukesh Jitendra Jha, Mahmadula Razi, Shravan Singh, Lokendra Rekwal, Vikas Chaturvedi, Chandra Mohan Varma, Ramesh Thakur

Abstract


Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Dual origin of a circumflex from both sinuses is extremely rare among them. We report a case of a patient who underwent primary percutaneous coronary intervention for acute inferior wall myocardial infarction where left coronary injection demonstrated normal obtuse marginal and right coronary injection demonstrated normal right coronary artery (RCA). On further probing, an anomalous left circumflex (LCx) artery was seen arising from RCA ostium which was subsequently cannulated and revascularized by deployment of 2.75 × 26 mm Xience Prime drug-eluting stent (Abott Vascular, USA). Herein, we report for the first time primary percutaneous coronary intervention of twin circumflex and also illustrate that anomalous circumflex can be missed if it arises from RCA ostium and if not probed carefully.




Cardiol Res. 2017;8(2):52-56
doi: https://doi.org/10.14740/cr530w


Keywords


Coronary artery anomalies; Twin circumflex arteries; RCA ostium; Primary PCI; Myocardial infarction

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