Anomalous Left Anterior Descending Coronary Artery Arising From the Right Coronary Artery: A Case Report

Abstract

Congenital anomalous coronary artery origins are rare, with a prevalence of 0.24–1.6%. Common configurations include left circumflex arising from the right coronary (RCA), left main coronary arising from the right coronary sinus and independent ostia for the left anterior descending (LAD) and left circumflex. One rare configuration that is not well described is the LAD arising from the RCA. A 68-year-old patient presented with non-ST elevation myocardial infarction, underwent coronary artery bypass grafting and was found to have a patent LAD arising from the RCA. In patients presenting with coronary artery disease and anomalous coronary anatomy, careful preoperative planning and intraoperative attention to patient anatomy is essential in identifying high-risk coronary anomalies and providing the correct and optimal treatments for these patients.

Plain language summary

Abnormal origins of the heart arteries are rare, affecting an estimated 0.24–1.6% of the general population. The two main coronary arteries are the right coronary artery (RCA) and left main coronary artery, which branches into the left anterior descending (LAD) and left circumflex artery. While several configurations have been described, one exceedingly rare configuration is the LAD arising from the RCA. A 68-year-old patient presenting with an acute coronary event undergoing coronary artery bypass grafting was found to have an LAD arising from the RCA. Patients presenting with coronary artery disease and abnormal coronary anatomy require careful preoperative planning and intraoperative attention to patient anatomy to identify high-risk coronary abnormalities and providing the optimal treatments for these patients.

Keywords:

• anomalous coronary artery
• coronary artery bypass grafting
• coronary artery disease
• left anterior descending artery

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at:www.tandfonline.com/doi/full/10.2217/fca-2022-0107

Author contributions

R EL-Andari, Q Duan, A Neufeld, J Nagendran: conception, data collection, writing original manuscript and revisions, approval of final version. All authors agree to be accountable for all aspects of the work.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

Written informed consent to publish this case was received from the patient.

Data availability statement

All data associated with this case report is included in the manuscript.