Angiographic anatomy of the left Kugel's artery

The left Kugel's artery is an uncommon but sometimes important collateral between the proximal circumflex artery and whatever artery supplies the crux of the heart. It passes anterior to the mitral valve ring, coursing in the interatrial septum, to anastomose usually with the atrioventricular node artery. The left Kugel's artery was prospectively identified on coronary arteriograms in 3.6% of patients with significant disease in dominant circumflex or right coronary arteries with associated collateral circulation. It was occasionally as large as 1 mm in diameter. The angiographic anatomy of this vessel is described.