Anat Cell Biol.  2015 Jun;48(2):144-146. 10.5115/acb.2015.48.2.144.

Dual left anterior interventricular coronary artery with a rare course in a Korean

• Cho JS
• Kim J
• Yoon SP

• KMID: 1845283
• DOI: http://doi.org/10.5115/acb.2015.48.2.144

Abstract

Dual left anterior interventricular coronary artery (also called left anterior descending artery, hereafter referred as LAD) is a rare congenital coronary artery anomaly. Notably, type IV dual LAD has never been reported in Koreans. During a routine dissection, a new variant of type IV dual LAD was found in a 57-year-old Korean male cadaver, whose cause of death was unknown. One LAD originated from the right coronary artery, coursed through the anterior interventricular sulcus, but did not reach the apex cordis. The other LAD arose from the left coronary artery, never entered the anterior interventricular sulcus through its course, but reached the apex cordis, where it met the posterior interventricular branch of the right coronary artery. This is the first report on a new variant of type IV dual LAD in Koreans, which is of clinical importance during procedures containing the coronary artery.

Keyword

Coronary vessel anomalies; Dual left anterior interventricular coronary artery; Korea

MeSH Terms

Arteries
Cadaver
Cause of Death
Coronary Vessel Anomalies
Coronary Vessels*
Humans
Korea
Male
Middle Aged

Figure

• 

  Fig. 1 Superior view of the great vessels and the coronary arteries. The right (1) and left (2) coronary artery arose from the right and left coronary orifices, respectively. The short left anterior descending artery (LAD) (3) originated from the right coronary artery. The left coronary artery trifurcated into the long LAD (4), the parallel LAD (5), and the circumflex (6) branches. 7, the septal branch from the long LAD; 7', the septal branch from the short LAD.

• 

  Fig. 2 Distribution of the coronary arteries. (A) Anterior view. (B) Left anterior oblique view. (C) Right anterior oblique view. (D) Posterior view. 1, the right coronary artery; 3, the short left anterior descending artery (LAD); 4, the long LAD; 5, the left parallel LAD; 6, the circumflex branch; 7, the septal branch from the long LAD; 7', the septal branch from the short LAD; 8, the right marginal branch; 9, the posterior interventricular branch; Ao, aorta.

Reference

1. Spindola-Franco H, Grose R, Solomon N. Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications. Am Heart J. 1983; 105:445–455.

2. Maroney J, Klein LW. Report of a new anomaly of the left anterior descending artery: type VI dual LAD. Catheter Cardiovasc Interv. 2012; 80:626–629.

3. Tuncer C, Batyraliev T, Yilmaz R, Gokce M, Eryonucu B, Koroglu S. Origin and distribution anomalies of the left anterior descending artery in 70,850 adult patients: multicenter data collection. Catheter Cardiovasc Interv. 2006; 68:574–585.

4. Bae YJ, Cha KS, Park JG, Jang CR, Lee HS, Kim MH, Kim YD, Kim JS. Dual left anterior descending coronary artery: incidence, angiographic features and clinical significance in the era of revascularization. Korean Circ J. 2000; 30:1092–1098.

5. Andreou AY, Avraamides PC. Short branch of type IV dual left anterior descending coronary artery running as an aberrant obtuse marginal branch: a previously undescribed arrangement. Clin Anat. 2009; 22:873–875.

6. Bhatia V, Arora P, Pandey AK, Kaul U. Type IV dual left anterior descending coronary artery: a rare anomaly. Heart Views. 2010; 11:64–66.

7. Stougiannos P, Tousoulis D, Trikas A, Stefanadis C. Anomalous origin and course of a dual left anterior descending coronary artery. Int J Cardiol. 2011; 146:e53–e55.

8. Andreou AY. The parallel left anterior descending coronary artery. Int J Cardiol. 2010; 138:219–220.

9. Lee Y, Lim YH, Shin J, Kim KS. A case report of type VI dual left anterior descending coronary artery anomaly presenting with non-ST-segment elevation myocardial infarction. BMC Cardiovasc Disord. 2012; 12:101.

10. Burton RA, Quinn TA, Kohl P. Rediscovering the third coronary artery. Eur Heart J. 2011; 32:1435–1437.

11. Murphy E. Cardiology review. 2nd ed. Philadelphia: WB Saunders Co.;2000. p. 871–875.

12. Ogden JA. Congenital anomalies of the coronary arteries. Am J Cardiol. 1970; 25:474–479.

13. Houyel L, Bajolle F, Capderou A, Laux D, Parisot P, Bonnet D. The pattern of the coronary arterial orifices in hearts with congenital malformations of the outflow tracts: a marker of rotation of the outflow tract during cardiac development? J Anat. 2013; 222:349–357.

14. Li J, Soukias ND, Carvalho JS, Ho SY. Coronary arterial anatomy in tetralogy of Fallot: morphological and clinical correlations. Heart. 1998; 80:174–183.

15. Chiu IS, Wu CS, Wang JK, Wu MH, Chu SH, Hung CR, Lue HC. Influence of aortopulmonary rotation on the anomalous coronary artery pattern in tetralogy of fallot. Am J Cardiol. 2000; 85:780–784.