Variant origin and course of left circumflex coronary artery
Arpandeep Randhawa1, Abhimanyu Saini2, Anjali Aggarwal3,4
1Department of Anatomy, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Insights
A rare variant origin of the left circumflex coronary artery (LCx) from the right aortic sinus was observed. This anatomical variation, though often asymptomatic, requires careful consideration during cardiac procedures.
Area of Science:
- Cardiovascular Anatomy
- Interventional Cardiology
Background:
- The left circumflex coronary artery (LCx) typically originates from the left aortic sinus.
- Variations in coronary artery origin, while recognized, can present unique challenges in clinical practice.
Observation:
- A specific case of LCx originating with the right coronary artery (RCA) from a common ostium in the right aortic sinus was identified in a 45-year-old female.
- This variant LCx followed a retroaortic course, positioned at the aortic annulus level and 6.6 mm above the mitral valve annulus.
Findings:
- The variant LCx exhibited a higher degree of luminal stenosis compared to the concurrently originating RCA and the left anterior descending artery (LAD).
- The anatomical course and origin of this variant LCx were meticulously documented.
Implications:
- Accurate anatomical knowledge of variant coronary artery origins, such as this retroaortic LCx, is crucial for the successful execution of percutaneous coronary interventions.
- Understanding this variation is vital for planning and performing cardiac surgeries, including aortic and mitral valve replacements, to avoid iatrogenic injury.
Abstract:
Variant origin of left circumflex coronary artery (LCx) from right aortic sinus is a well-recognized coronary variation, usually without any clinical consequences. However, the variant origin and trajectory of the artery may have major implications during percutaneous coronary intervention, coronary artery surgery, aortic and mitral valve replacement procedures. We observed a variant LCx in a heart specimen belonging to 45-year-female with no history of hypertension, diabetes mellitus and coronary artery disease. The artery arose along with the right coronary artery from a common ostium in right aortic sinus and depicted a retroaortic course. The vessel was located at the level of aortic annulus and 6.6 mm above mitral valve annulus. The degree of luminal stenosis in variant LCx was higher than that in right coronary artery (RCA) and left anterior descending artery (LAD). Appropriate anatomical knowledge of the location and course of variant LCx is important for successful coronary interventions and valve replacement procedures.
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