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. 2009:2009:bcr08.2008.0772.
doi: 10.1136/bcr.08.2008.0772. Epub 2009 Apr 15.

Congenital absence of left circumflex artery with a dominant right coronary artery

Fariha Sadiq Ali  1 , Sohail Abrar Khan, Javed Majid Tai, Saulat Husnain Fatimi, Sajid Hameed Dhakam
Affiliations

Congenital absence of left circumflex artery with a dominant right coronary artery

Fariha Sadiq Ali et al. BMJ Case Rep. 2009.

Abstract

Case 1: a 40-year-old man was admitted to our hospital with progressively worsening post myocardial infarction angina. Cardiac catheterisation was performed, which showed total occlusion of the left anterior descending artery (LAD) and the left circumflex artery (LCX) was not visualised. The right coronary artery (RCA) was a large artery supplying the left ventricular inferior and posterolateral walls and filling the LAD artery in retrograde. The patient was referred for coronary artery bypass grafting. Peroperative findings confirmed the angiographic evidence of congenitally absent LCX artery.Case 2: a 39-year-old man with a family history of premature coronary artery disease underwent coronary angiography for the work-up of chest pain. A coronary angiogram showed normal LAD artery and absence of left circumflex system. The RCA was superdominant. An aortogram confirmed no anomalous origin and true absence of LCX artery.

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Figures

Figure 1
Figure 1
Left coronary angiogram in left anterior oblique (LAO) view with caudal angulation showing absence of left circumflex artery.
Figure 2
Figure 2
Right coronary angiogram in left anterior oblique view showing super dominant artery with 70% lesion in mid vessel and filling the occluded left anterior descending artery in retrograde.
Figure 3
Figure 3
Left coronary angiogram in right anterior oblique (RAO) view with caudal angulation showing absent left circumflex artery.
Figure 4
Figure 4
Right coronary angiogram in right anterior oblique (LAO) view showing large right coronary artery with large branches supplying the left ventricular posterolateral wall.
Figure 5
Figure 5
Aortic root angiogram showing absent left circumflex artery.
Figure 6
Figure 6
Peroperative finding of absence of left circumflex artery in the atrioventricular groove.
See this image and copyright information in PMC

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