Woven coronary artery anomaly presenting as sudden cardiac death

Woven coronary artery is a rare anomaly characterized by thin channels arising from the coronary artery and reanastomosing at the distal arterial segment. To our knowledge, no data are available currently on the histologic structure of the woven segment. A 39-year-old man presented with sudden atypical chest pain while he was practicing cycling. During the transfer of the patient to the hospital, he suffered cardiac arrest. After 50 min of cardiopulmonary resuscitation, the patient could not return to sinus rhythm and died. At autopsy, the patient presented a woven right coronary artery associated with an old myocardial infarct of the posterior wall of the left ventricle. We describe for the first time a case of woven coronary artery associated with sudden death. This case allowed us to study the histopathology of the channels that make up the malformation. These showed well-conformed walls with absence of breaches. A complete review of the literature on the subject is included.