Right coronary artery originating from left anterior descending artery: a case report

Abstract

Right Coronary Artery (RCA) originating from left anterior descending artery is a very rare congenital coronary artery anomaly. A 66-year-old man presented with hypertension and complaints of exertional chest pain. The angiography was performed. Aortic root angiography showed no coronary ostium orginating from the right sinus of valsalva. Right coronary artery was vizualized as anomalously originating from the midportion of left anterior descending artery. Severe stenosis were seen in ostium of anomalous right coronary artery, in midportion of left anterior descending and in midportion of circumflex artery. The patient was referred for coronary artery bypass grafting. The patient underwent coronary artery bypass surgery for three vessels. He was discharged home on postoperative day 7 without any complication. His echocardiogram on follow-up visit revealed good biventricular function.

A patient with anomalous right coronary artery originating from the left anterior descending artery who underwent complex percutaneous coronary intervention: A case report

“…A variety of anomalous origin of the RCA has been reported, including the left anterior sinus with variable courses, ascending aorta above the sinus level, descending thoracic aorta, left main coronary artery, circumflex coronary artery, the pulmonary arteries, or below the aortic valve [7]. The origin of the RCA from the LAD is rare in the literature and considered to be a variant of a single coronary artery [1].…”

Anomalous Origin of the Right Coronary Artery from the Mid-Portion of the Left Anterior Descending Artery in a Patient with Single Left Coronary Artery: A Rare Coronary Artery Anomaly and Review of Literature

“…The anomalous vessel with the interarterial course (between aorta and pulmonary arteries) is considered malignant or serious and the prognosis is better for a vessel with an anterior course .If the course of RCA is not between the aorta and pulmonary artery, this anomaly has a better prognosis (2). Benign anomalous addresses an anomalous in which the LCX originates from the right circulation (26,27) and we will not discuss this anomaly in this article.…”

“…Cardiac surgery is very important in these patients. Recommended surgical therapies in this anomaly include ostioplasty, bypass graft of the RCA, reimplantation of RCA to the aorta, and pulmonary artery translocation (2,3). However, the long-term outcome of such therapies is not confirmed.…”

“…Some studies based on autopsy cases have shown that slit-like orifice structure and acute angle take off are more common in sudden cardiac death patients (2,25,29).…”

“…Origination of the right coronary artery (RCA) from the left anterior descending (LAD) artery is a type of single coronary artery that is an extremely rare coronary artery abnormality (incidence 0.024%) (1). It is usually an incidental finding during coronary angiography (2).…”