Anomalous right coronary artery originating from the left anterior descending artery: Case report and review of the literature

Joel Wilson, Hassan Reda, John C. Gurley

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


The anomalous origin of the right coronary artery (RCA) as a branch of the left anterior descending (LAD) artery is a very rare variation of single coronary artery. At least 36 cases have been described previously in the literature. The vast majority of previous reports have described a single anomalous vessel with its origin after the first septal perforator of the LAD, which courses anterior to the right ventricular outflow tract to reach territory normally served by the right coronary artery. Of 35 cases in structurally normal hearts, 19 (54%) patients had > 50% narrowing in one or more epicardial coronary arteries (54%), at least 14 (40%) of whom required revascularization. Thirteen cases (37%) did not have significant coronary artery disease, while the remaining 3 cases were unclear. The current report reviews previous reports of this anomaly and describes a patient with an anomalous RCA from the mid-LAD, in whom heart block, back pain and dyspnea was the initial manifestation of ischemia. On heart catheterization, there was significant coronary artery disease in the LAD proximal to the origin of the anomalous artery. The patient was successfully revascularized with a unique sequential left internal mammary artery bypass to the anomalous vessel and LAD.

Original languageEnglish
Pages (from-to)195-198
Number of pages4
JournalInternational Journal of Cardiology
Issue number3
StatePublished - Nov 2009


  • Adult
  • Aged
  • Angina pectoris/etiology
  • Coronary angiography
  • Coronary artery bypass
  • Coronary artery disease
  • Coronary vessel anomalies
  • Heart conduction system
  • Humans
  • Male
  • Middle aged
  • Pacemaker, artificial

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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