Clinical Image

Dual Left Anterior Descending Artery in ALCAPA: A Rare Malformation

Nikunj Vaidhya1, Kartik Patel1*, Prashant Agrawal2, Megha Seth3 and Amit Mishra1
1Department of Cardiovascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center, Gujarat, India
2Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Center, Gujarat, India
3Department of Cardiac Radiology, U. N. Mehta Institute of Cardiology and Research Center, Gujarat, India


*Corresponding author: Kartik Patel, Department of Cardio vascular and Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center, (Affiliated to B. J. Medical College), New Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India


Published: 05 Sep, 2017
Cite this article as: Vaidhya N, Patel K, Agrawal P, Seth M, Mishra A. Dual Left Anterior Descending Artery in ALCAPA: A Rare Malformation. Clin Surg. 2017; 2: 1609.

Clinical Image

Left main pulmonary artery was arising from Main pulmonary artery from posterior sinus and it was divided into short lad and left circumflex artery. Short LAD gave one septal branch and then terminated large diagonal branches which were tortuous in their course. LCX showed normal course in the left atrioventricular groove. Right coronary artery showed normal origin from the right coronary cusp. RCA and its acute marginal artery were dilated and it also gave Lond LAD artery coursing in the anterior interventricular groove and reaching up to the cardiac apex. Long LAD gave origin to multiple septal and diagonal branches which supplied the interventricular septum and the anterior wall of the left ventricle.

Figure 1 and 2

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Figure 1 and 2
CT coronary angiography demonstrated anomalous origin of LAD with combination of dual LAD and ALCAPA.
MPA: Main Pulmonary Artery; LAD: Left Anterior Descending Artery; RCA: Right Coronary Artery; LCX: Left Circumflex Artery
MPA: Main Pulmonary Artery; LAD: Left Anterior Descending Artery; RCA: Right Coronary Artery; LCX: Left Circumflex Artery