Intercoronary Communication Between Left Anterior Descending Artery and Totally Occluded Right Coronary Artery

Abstract

The author presents a patient with chronic total occlusion of the right coronary artery with a large lumen communication to the distal left anterior descending artery as a single conduit. The diameter of this connection was very large and equaled the distal left anterior descending artery diameter. The unusual finding of a large lumen connection between the left anterior descending artery and right coronary artery most likely represents a congenital coronary anomaly.

Inter-Coronary Communication: A Rare Anomaly in Unusual Site

“…On the other hand the coronary collaterals typically have a small diameter of less than 0.5 mm, epicardial or intra-myocardial, carrying blood from a vessel with normal flow to a vessel segment after the occlusion or sever stenosis. The extent of these collaterals is related to the angina duration, usually disappearing after revascularization and reappearing if stenosis or occlusion reoccurs [10]. In our case the large anterior epicardial > 1 mm vessel originates from the right coronary ostium and runs along the anterior surface of the right ventricle to the end in the proximal segment of the left anterior descending artery, and in the same time there is posterior intercoronary continuity between the right coronary artery crux and the distal left circumflex artery.…”