My 14 yr old has a dangerous single right coronary artery...

Question

Does anyone here have or know someone with a single right coronary artery? Really hoping to find others with this uncommon coronary artery anomaly ~ If so please message me :) My 14 yr old has it and his variation is the dangerous one and trying to weigh all options regarding. He had a cath on Thursday and they said his left artery arises from the right and goes between the great vessels. Others with this are found after sudden death or when symptomatic. There is very limited or no data on those with it living without concerns his doc said. They are doing a stress test in two weeks to see if he is symptomatic to decide if to treat or not and it scares me. I dont know whats worse, the surgery (does this mean he is now ok and can resume a normal life?) or waiting to see if he suddenly has an issue and hoping we call 911 on time. Really scared and desperate for advice ~ Thanks so much!

This discussion is related to rare heart defect.

Proudmomma3xs · Answer

Thank you for your post :)  This is a rare anomaly sadly so info is limited.  I saw the cath photos and to me it looked like there are two arteries arising on the right.  I asked him about it and he said it is still a single right artery so maybe it starts as one and splits, who knows.  And I surely dont know what I am looking at. The dx from his CT said the left artery arises from the right. Doc said it is still consider a single right artery. The left one arises from the right  and goes to the appropriate place its just the direction it took that is very serious.  The problem is that it goes between the great A & P arteries which is very dangerous.  Others often found with this have it go around, in front or behind.  It can get compressed or kinked during exertion.  There can for some be no symptoms and lead to sudden death. They can def fix it, they will do a bypass it is just that because it is often found after sudden death or when symptomatic there is limited info on it. I really want to find others who have had this or know someone with it ~ I am a firm believe that docs know SO much but those are have experienced it can also shed so much light too.  Thank you SO much!!  Robin ~

ed34 · Answer

Sorry, I missed some of your points. I think the stress test will be valuable in determining it the single vessel can indeed supply enough blood to the complete heart. If not, then I would suggest surgery because of the long term implications and his quality of life. If arteries are removed from the chest and used as grafts, these last a lifetime, whereas veins do not. If they supply feeds to the individual vessels, then he is in reality at no more risk than you or I of having a heart attack. Due to his age, I would ask lots of questions regarding their decision, you want to obviously make sure he is having the best solution for the long term.
Please keep us informed and take care.

ed34 · Answer

I'm very sorry but this is a new condition to me, I had never heard of it until your post. Am I correct in assuming that the right coronary artery is fed from the Aorta (normal) but the left artery is not (LAD)? and the right coronary artery goes around the heart to become the left artery, essentially making it one long continuous vessel instead of two? This would mean the Circumflex is also fed from the right coronary artery, through the left.
If this is the case, I am wondering why they can't use an artery from the chest (Lima or Rima) and graft it from the Aorta to the Left artery as a backup. I am assuming the 'danger' is if a blockage forms, essentially killing all blood to the heart? Why can't they go one further and graft another artery between the Aorta and the Circumflex, giving individual feeds to all three major vessels?
Just a thought.