Dual left anterior descending coronary artery – an unusual variant

Abstract

Dual Left Anterior Descending (LAD) Coronary artery is a very rare coronary artery anomaly. The origin of short LAD coronary artery from left main (LM) coronary artery shaft is a very rare variant. Our patient is a 60 year old male who was thrombolysed with Tenecteplase elsewhere for acute anterior wall myocardial infarction. Coronary angiogram done in our institution revealed normal origin of left and right coronary arteries from aorta. A short LAD is seen arising from LM coronary artery shaft entering proximal portion of anterior interventricular groove giving rise to small septal and diagonal branches. The LM coronary artery then bifurcates into LAD (long LAD) and left circumflex coronary arteries. The long LAD gives rise to major diagonals and septals and enters the anterior interventricularsulcus (AIVS) distally. Only one case report of this variant has been reported in literature till date.