Long main stem of left coronary artery with resultant meandering course of left circumflex artery

Abstract

We report a case of a 49-year-old woman with a longer than usual main stem of the left coronary artery resulting in a meandering course of the left circumflex artery and a partially empty left atrioventricular groove. The case also highlights the potential implications of this incidentally detected coronary artery variant.

Reply to Letter to the Editor: “Reevaluating the Case of an Allegedly Absent Circumflex Artery: A Detailed Analysis of İnce et al.’s Report”

“…Additionally, the authors noted that the length of the LMCA in our case is abnormally long, and the circumflex artery is similar to that reported by Khurana et al 7 In that case report, 19.2 mm of LMCA length was defined as unusually long. Also, in a study, the mean length of LMCA was reported to be 9.5 mm, and the maximum length was 32 mm.…”

Reevaluating the Case of an Allegedly Absent Circumflex Artery: A Detailed Analysis of İnce et al.’s Report

“…In a study involving 100 normal-sized postmortem hearts, it was found that the average length of the left main coronary artery was 5.5 mm. 2 The case reported by İnce et al 1 is considered to have an abnormally long left main stem, and the course of its long left main stem and circumflex artery is similar to that of the circumflex artery reported by Khurana et al 3 In the case reported by Khurana et al, 3 the left main coronary artery exceeded the usual length (measuring 19.2 mm) before bifurcating into the left anterior descending artery and the left circumflex artery. The left circumflex artery traversed the anterolateral wall of the basal segment of the left ventricle, then turned posteriorly (making a 90° turn) to return to the distal left atrioventricular groove.…”

“…The case reported by Khurana et al 3 fully demonstrates the vasculature of the lateral wall, showing the elongated left main stem and the tortuous course of the circumflex artery, which emerges later.…”