A new anomaly of the left anterior descending artery: Type X dual LAD

Abstract

Dual left anterior descending (LAD) coronary artery anomaly is traditionally classified as four types anomaly by classical coronary angiogram. Nowadays, coronary computed tomographic angiography (CCTA) allows clinicians to understand other variants of dual LAD anomaly. Up to date, 9 types of dual LAD variants detected from not only classical coronary angiogram but also CCTA imaging have been reported. In the present case, we aimed to show a novel dual LAD anomaly, which is demonstrated by CCTA during preoperative evaluation and it has not been previously reported.

A rare case of type X dual left anterior descending coronary artery

“…In this study, the anomalous LAD origin and the course was consistent with the type X variety of dual LAD as described in the literature, and presented in Table 1 and hence a rare entity [1].…”

“…Based on classic coronary angiogram and coronary computed tomographic angiography (CCTA) imaging, the condition is traditionally divided into 9 subtypes. Recently, a case of novel LAD was published in the literature, and that was named as class X [1]. We report a case that has the same features as class X.…”

Four Coronary Arteries Separately Originating from the Right Sinus of Valsalva

“…The LCA-1 became the obtuse marginal branch or the ramus intermedius artery after branching off into the septal branch, the LCA-2 became the main LCX, and the LCA-3 became the LAD. These arteries formed "dual LAD" (15)(16)(17) and "twin LCX" (18)(19)(20)(21).…”

“…Dual LAD is another rare anomaly, characterized by a short LAD and a long LAD (15)(16)(17). The short LAD terminates high in the anterior interventricular groove, while the long LAD follows a variable course outside of the anterior interventricular groove and returns to the interventricular groove distally.…”

Types of Dual LAD—Nomenclature confusion!!!

“…In an article published by Celik et al 1 in Indian Heart journal (available online on 18 December 2015), ten types of Dual LAD (left anterior descending artery) have been mentioned. In the tabular form, they have mentioned all the types according to the origin and course of short and long LAD.…”