A CLINICAL CASE OF CORONARY ARTERY ABNORMALITY IN A LONG-LIVED PATIENT: ORIGIN OF THE RIGHT CORONARY ARTERY ABOVE THE CORONARY SINUS

Coronary artery structural abnormalities can be classi†ed into several key categories, one of which is abnormalities of normal origin and course. Especially rare are such features as the absence of the left coronary artery stem, abnormal location of the origin, and its abnormal position in other coronary sinuses or outside of them. This article presents a case report of a clinical case of intravital diagnosed right coronary artery branching above the coronary sinus of the ascending aorta diagnosed in a long-lived patient with grade 3 aortic valve stenosis, discovered when coronarography was performed prior to an upcoming transcatheter aortic valve replacement. Despite the obvious clinical signi†cance of this anomaly for patients and practical signi†cance for physicians of various specialties, there are very limited literature data on this pathology. The number of cases of lifetime detection of coronary artery malformations is increasing due to the wider and more accessible use of imaging diagnostic methods (contrast-enhanced computed tomography and magnetic resonance imaging, coronary angiography). Coronary artery anomalies are most often detected by coronary angiographic examination during the procedure in symptomatic patients. Given the rapid development and implementation of visualizing instrumental diagnostic methods into routine practice, and due to the improvement of professional medical skills, the detection of such anomalies, as well as the prevention of possible lethal outcomes, has become much faster and easier. The use of noninvasive and invasive diagnostic methods as screening in asymptomatic patients allows for detection of anomalies beginning from a young age. In our case, an incidental †nding during coronary artery angiography allowed us to avoid potential complications during further surgical intervention. This clinical case suggests a higher prevalence of asymptomatic coronary artery anomalies that do not a—ect the quality of life.