Images in Cardiovascular CTNovel variant of dual left anterior descending coronary artery
Section snippets
Case history
A 29 year-old man presented with atypical chest pain. Physical examination, electrocardiogram, and cardiac enzymes were normal. Coronary computed tomographic angiography (64-slice) showed a novel variant of dual (duplicated) left anterior descending artery (LAD) coronary artery. The short LAD had a separate origin from the left coronary sinus and terminated in the proximal interventricular groove, giving off the first septal perforator. The long LAD originated from the right coronary sinus
Discussion
Duplication of the LAD is a rare anomaly and has been categorized into 4 angiographic subtypes,1, 2 based on the origin, course, and termination of the short and long LAD as shown in Table 1. A recent report has shown the coronary computed tomographic angiography characteristics of dual LAD.3 Our case is unique in that the short LAD originates independently from the left coronary sinus and that the long LAD arises from right coronary sinus and has an intramyocardial course before reaching the
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Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications
Am Heart J
(1983)
Cited by (35)
Case analysis of a RIII-C single coronary artery with type IV dual LAD and right-dominant triple PDA
2023, Translational Research in AnatomyA rare case of type X dual left anterior descending coronary artery
2019, Journal of Cardiology CasesCitation Excerpt :Duplication of LAD has been categorized into 4 angiographic subtypes based on the origin, course, and termination of the S- and L-LAD [3]. Based on CCTA imaging, five additional subtypes including a new variant of type X were later published [3,7,8]. In this study, the anomalous LAD origin and the course was consistent with the type X variety of dual LAD as described in the literature, and presented in Table 1 and hence a rare entity [1].
Percutaneous coronary intervention in a rare case of Type V dual LAD
2018, Journal of Cardiology CasesA new variation of dual left anterior descending coronary artery
2016, Journal of Cardiology CasesCitation Excerpt :To our knowledge, this combination of dual LAD has not been reported in the literature and this new variation may show a rare risk of coronary ischemia due to its intramyocardial course as compared with type V. Utilization of CCTA is advocated for full evaluation of dual LADs [1,4–6]. In types IV–VI, the anatomical determination of the course of anomalous long LAD is considered to be clinically important to rule out a high-risk course by CCTA [4,5].
Could Descending Septal Artery Be Another Variant of the Dual Left Anterior Descending Artery?
2016, Revista Espanola de CardiologiaA new anomaly of the left anterior descending artery: Type X dual LAD
2015, Indian Heart JournalCitation Excerpt :However, coronary computed tomographic angiography (CCTA) imaging allows clinicians to notice other variants of dual LAD anomaly in current era.3 Uptil date, 9 types of dual LAD variants detected from not only classical coronary angiogram but also CCTA imaging have been reported.2–6 In the current case, we tried to present a novel case of dual LAD anomaly demonstrated by CCTA during preoperative evaluation which has not been previously reported.
Conflict of interest: The authors report no conflicts of interest.