Double left anterior descending coronary artery arising from the left and right coronary arteries is a very rare congenital coronary artery anomaly. In this case, there was also a circumflex artery arising from the right sinus Valsalva and in association with severe rheumatic valve disease. Subsequently, the patient underwent mechanical aortic valve replacement with a 21-mm bileaflet mechanical aortic valve and coronary artery bypass grafting. We performed coronary artery bypass grafting of 3 vessels, including the left internal mammary artery to the large diagonal branch and the saphenous vein graft to the circumflex artery and the right coronary artery, under cardiopulmonary bypass. In this report, we describe an unusual case of this combination in association with both atherosclerosis and rheumatic aortic and mitral valve disease.
[Show abstract][Hide abstract] ABSTRACT: Dual left anterior descending coronary artery (LAD) originating from the left main stem and the right coronary artery (RCA) (Type IV dual LAD) is a very rare coronary artery anomaly. Association of this anomaly with the anomalous origin of the circumflex artery from the RCA is a very rare occurrence. In this report, we describe a patient presenting with acute lateral wall myocardial infarction who subsequently was found to have this coronary anomaly.
The Journal of invasive cardiology 01/2009; 20(12):669-70. · 0.95 Impact Factor
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