Dual Left Anterior Descending Artery With Dominant Long Left Anterior Descending Artery Ascending as Posterior Interventricular Artery

Abstract

A dual left anterior descending coronary artery (LAD) system is a rare anatomic variant of the coronary circulation. In the most common form (type I), the dual LAD can be recognized by an early bifurcation of the LAD proper into a “short” LAD (Fig 1; yellow star) giving rise to all septal perforators and a “long” LAD (Fig 1; green star) giving rise to all diagonal branches (Fig 1; LV = left ventricle). A “dominant” LAD, described as an apical wraparound LAD artery, continuing as the only posterior interventricular (PIV) arterial branch, is also exceedingly uncommon.