CTICasesSingle Coronary Artery
Imaging findings
CT coronary angiography shows a single coronary artery arising from the right coronary cusp. The single artery supplies the entire coronary circulation, with a large branch corresponding to the LAD coursing through the interventricular septum to supply the left ventricle. There is no coronary artery arising from the left coronary cusp.
Key takeaways
A single coronary artery is a rare congenital anomaly where the entire coronary system arises from a single aortic ostium. The clinical significance depends on the pathway of the aberrant branches (especially if they take an interarterial course between the aorta and pulmonary artery, which can be malignant). A transseptal course is generally benign but represents a surgical hazard during valve replacement or septal myectomy.
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