Primary Percutaneous Coronary Intervention in a Patient with Acute Inferior Myocardial Infarction and Agenesis of Right Coronary Artery. "In Search of a Coronary Ostium"
Gabriele Giacomo Schiattarella
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
Fabio Magliulo
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
Vito Di Palma
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
Giovanni Esposito
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
Plinio Cirillo *
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
*Author to whom correspondence should be addressed.
Abstract
Coronary arteries with anomalous origin from the aorta may represent a trouble for interventional cardiologist, in particular in setting of acute coronary syndromes. Research of coronary ostium may cause crucial delay in reperfusion with important consequences for myocardial salvage. We described a case of inferior ST-elevation myocardial infarction (STEMI) complicated by bradyarrythmia and hypotension, and treated with primary percutaneous coronary intervention (PCI) in a patient with agenesis of right coronary ostium. The patient had only a single left coronary artery occluded at the distal portion before a bifurcation with a huge branch that encompassed the theoretical territories of right coronary artery.
Keywords: Coronary anomalies, percutaneous coronary intervention, ST-elevation myocardial infarction