Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Artery: A Rare Angiographic Finding

Abstract

The right coronary artery originating from the left coronary system is an extremely rare variation of the single coronary artery anomaly in which the prognosis is usually benign provided that the anomalous vessel does not cross between the aorta and the pulmonary artery. The clinical significance of coronary anomalies is usually determined by underlying anatomic features of the wrong coronary origin and/ or coronary atherosclerosis. Although coronary angiography is an important diagnostic method, new non-invasive methods such as coronary computed tomography angiography and cardiac magnetic resonance imaging have important roles to play in characterizing this coronary anomaly. It should be noted that the management strategy of these patients may vary based on clinical presentation, anatomical details and additional findings. We describe a case of a man with occasionally detected right coronary artery originating from the left coronary system, treated with coronary artery by-pass because of critical two vessel disease. The anomalous right coronary artery was surprisingly untouched from atherosclerotic lesions.

The Origin of The Posterior Descending Artery from the 1st Septal Perforator: A Rare Anomaly

“…The septal origin of the PDA is very rare anomaly and should be considered under the category of hyper-dominant LAD. The entire RCA or PDA can originate from the 1st septal perforator [2]. The clinical significance of this variant is that it could be fatal if LAD occludes before the septal as it will involve a larger myocardium secondary to ischemia/infarction.…”