Background: Single coronary artery is a rare congenital coronary artery anomaly with the incidence of approximately 0.03%-0.05%. Its coexistence with severe aortic stenosis (AS) is even rarer. Patients who undergo transcatheter aortic valve implantation (TAVI) have a risk of coronary obstruction (1%) which will be more lethal when the origin of the coronary artery is single.
Case report: An 81 year-old female was referred to our institution for severe AS. Her coronary angiography revealed a single coronary artery originating from right sinus of valsalva. Since the patient had a high risk for aortic valve surgery, the cardiac team decided to perform transfemoral TAVI with a self-expandable valve.
Conclusion: We presented a successful case of TAVI with Medtronic CoreValve (Medtronic; Minnesota, USA) in a patient with single coronary artery after discussing the base of our strategy for preferring self-expandable valve. To the best of our knowledge, this is the second case of CoreValve implantation in such a patient in the literature. We suggest that the self-expandable valve may be the first choice in these patients because of its recapturable design.
Keywords: Coronary obstruction; self-expandable valve; single coronary artery; transcatheter aortic valve implantation.