Coronary stenting in a patient with single coronary artery and double-vessel disease!

A 52-year-old female with exertional angina of class II severity was referred to us. Her coronary angiogram revealed an anomalous single coronary artery from left coronary sinus. Its circumflex branch continued in the right AV groove to supply the right coronary artery territory. Significant stenoses were found in the left anterior descending and circumflex arteries. In view of her persistent angina despite optimal antianginals, percutaneous intervention of the stenosed arteries was done, after which the symptoms abated. Single coronary artery is a rare coronary anomaly, with reported prevalence of 0.024%-0.066%. It is usually asymptomatic. Coronary angioplasty of such rare anomalous vessels for atherosclerotic disease has been reported previously. We describe stenting of both the major branches of an anomalous single coronary artery in a patient with atherosclerotic coronary artery disease with a brief review and discuss the issues with intervention on single coronary artery.