Double left anterior descending artery: Congenital anomaly or normal variant of coronary arteries?

Abstract

A 73-year-old female patient was referred for coronary artery computed tomography angiography (CTA) due to dyslipidemia, hypertension, and mild ventricular arrhythmia. The study demonstrated a double left anterior descending artery (LAD) Type 1 variant (Fig. 1A) and significant atherosclerotic lesions in the coronary arteries. Conventional coronary angiography confirmed presence of an anomaly and significant atherosclerotic lesions within the second marginal branch (Mg 2) and the right coronary artery (RCA). The patient was treated with percutaneous coronary intervention (PCI) of Mg 2 and RCA with drug-eluting stenting (DES).A 63-year-old female smoker with hypertension, had a positive stress test with low exercise tolerance (5.9 METS) and significant ST depression in leads II, III, aVF, V5 and V6, with chest pain. The 24-h Holter electrocardiography monitoring demonstrated ventricular arrhythmia with nonsustained ventricular tachycardia (nsVT). The CTA revealed multifocal significant atherosclerotic lesions and dual LAD Type 1 (Fig. 1B). The patient did not consent to coronary angiography.Computed tomography angiography is the preferred imaging method in the assessment of coronary arteries anomalies. The main advantages

Dual left anterior descending artery: Case series based on novel classification and its therapeutic implications

“…described 10 cases of Group I-AS [Intra-myocardial course]. 21 Small case series included 2 case reports having a cluster of 3 and 4 cases each 9 , 10 , 11 , 12 while 5 case reports constituted 2 cases each, 13 , 14 , 15 , 16 , 17 the remaining 129 were single patient case reports.

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“… 5 LAD 1 misinterpreted as LAD occlusion in acute anterior wall myocardial infarction 29 , 42 IV Group II Especially, in the absence of a retrograde flow, one should look for a separate coronary artery flowing from the RCA – ‘Missing Artery’. Surgical Implications 1 Prepulmonic course of the LAD 2 17 IV, VIII, X, XI Group II-A Group III-PA With volume overload (atrial septal abnormalities, tricuspid regurgitations, etc.) it is at risk of damage to the LAD 2 during median sternotomy.…”

Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction

“…1B). The left anterior descending coronary artery (LAD) supplies segments 1,2,7,8,13,14, and 17, the right coronary artery (RCA) supplies segments 3, 4, 9, 10, and 15, while the left circumflex coronary artery (LCx) supplies segments 5, 6, 11, 12, and 16 [11]. However, coronary arteries may be anomalous and their anatomy varies from patient to patient, creating a limitation of the AHA model [12][13][14][15].…”