Dual Left Anterior Descending Artery with abberrent left circumflex artery: dual abberrency- a multi-modality imaging based identification.

Abstract

Dual left anterior descending (LAD) artery with separate origin of the long LAD with left main coronary artery (LMCA) continuing as short LAD is very rare. A 67-year-old diabetic, and hypertensive male was admitted with history of exertional dyspnoea. He underwent coronary angiography, which showed LMCA continuing as short LAD with early termination while single trunk from right coronary sinus was giving rise to long LAD, right coronary artery, and left circumflex artery (LCx). The long LAD, running on the right side of the anterior interventricular groove, entered the groove distally while anomalous LCx which was dominant, was following a retro-aortic course. These were subsequently confirmed on Multidetector computed tomography angiography (MDCT). Therefore, dual LAD with long LAD, dominant anomalous circumflex artery, and right coronary artery sharing a single, and common origin is very rare and to the best of our knowledge, is being reported for the first time.