Coronary artery bypass in a patient with complex coronary artery anomaly

摘要

I read with interest the paper of Saxena and colleagues1, and I would like to congratulate them on successful coronary artery bypass grafting in a patient with a very rare complex coronary artery anomaly. Nevertheless, I have a doubt about the Tightness of the diagnosis of single coronary artery with left anterior descending (LAD) and left circumflex (LCx) coronary arteries originating from the right coronary artery (RCA). As we know, in patients with the LAD originating from the RCA, the large arterial trunk arises from the RCA, crosses anteriorly the infundibulum of the right ventricle, and joins the anterior interventricu-lar sulcus (AIVS) at its midportion. This transverse trunk then gives rise to the proximal and distal portions of the LAD, which fill retrogradely and antegradely along the AIVS.2 In the case presented by Saxena and colleagues1, we can see that the transversal trunk, after reaching the AIVS, gives rise only to the distal portion of the LAD (Figure 1). Taking a good look at the coronary angiogram, we can see that the proximal AIVS receives blood from the artery termed LCx by the authors.