A case of crossing coronary arteries

Abstract

We present the case of a patient in whom coronary angiography, performed due to severe calcific aortic stenosis, revealed crossing between the left anterior descending artery and the first diagonal branch. There is only a single report presenting this particular coronary anatomy, whereas this is the eleventh case of crossing coronary arteries ever reported. The clinical implications of this variant coronary anatomy with regard to diagnostic angiography and selection of revascularization procedures are briefly discussed.

Case 2/2019 - Man with Arrhythmogenic Cardiopathy Followed by Rapidly Progressive Heart Failure

“…The crossing of epicardial branches is an anomaly of the intrinsic anatomy of the coronary arteries and is quite rare, with few cases having been described in the literature. 20 , 21 One might question whether there was compression of the arterial segments involved in the epicardial crossing, but in the absence of obstructive coronary alterations and localized ischemic myocardial lesions, anatomopathological examination is limited for such evaluation. Left ventricular hypertrophy and dilatation, as well as diffuse interstitial myocardial fibrosis can be explained by the bicuspid aortic valve dysfunction.…”

Proximal crossing of the left coronary arteries with a septal branch arising from the left circumflex artery

“…Crossing of coronary arteries (COCA) is a very rare finding with unknown incidence with only few reported cases and often associated with separate ostia. 2 Knowledge of the exact origin and course of anomalous coronary arteries can be helpful prior to invasive angiography and intramyocardial course must be excluded prior to bypass surgery. 2 …”

“… 2 Knowledge of the exact origin and course of anomalous coronary arteries can be helpful prior to invasive angiography and intramyocardial course must be excluded prior to bypass surgery. 2 …”