Why the study?
The anomalous origin of the left anterior descending artery arising from the right coronary artery is a rare configuration that is not well described.
Highlights the importance of careful preoperative planning and intraoperative attention to identify rare congenital coronary anomalies such as the LAD arising from the RCA.
Rare LAD-from-RCA anomaly can underlie NSTEMI; case report leaves open optimal revascularization strategy.
Congenital anomalous coronary artery origins are rare, with a prevalence of 0.24-1.6%. Common configurations include left circumflex arising from the right coronary (RCA), left main coronary arising from the right coronary sinus and independent ostia for the left anterior descending (LAD) and left circumflex. One rare configuration that is not well described is the LAD arising from the RCA. A 68-year-old patient presented with non-ST elevation myocardial infarction, underwent coronary artery bypass grafting and was found to have a patent LAD arising from the RCA. In patients presenting with coronary artery disease and anomalous coronary anatomy, careful preoperative planning and intraoperative attention to patient anatomy is essential in identifying high-risk coronary anomalies and providing the correct and optimal treatments for these patients.
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EL‐Andari et al. (2023) studied this question.
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