Surgical and Radiologic Anatomy

, Volume 39, Issue 3, pp 333–336 | Cite as

Variant origin and course of left circumflex coronary artery

  • Arpandeep Randhawa
  • Abhimanyu Saini
  • Anjali Aggarwal
  • Tulika Gupta
  • Uma Nahar Saikia
  • Manoj Kumar Rohit
  • Daisy Sahni
Anatomic Variations
  • 171 Downloads

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.

Keywords

Variant left circumflex coronary artery Atherosclerosis Percutaneous coronary intervention Prosthetic valve replacement 

Notes

Compliance with ethical standards

Funding

The study was supported by the grant from Indian Council of Medical Research, New Delhi, India. Grant Number—3/1/3/JRF-2010/HRD-77(11352).

Conflict of interest

None.

References

  1. 1.
    Acosta-Velez JG, Garcia del Blanco B, Guindo J et al (2014) Acute artery occlusion during transcatheter aortic valve replacement in a patient with an anomalous origin of the circumflex artery. JACC Cardiovasc Interv 11:1324–1325CrossRefGoogle Scholar
  2. 2.
    Aydin M, Ozeren A, Peksoy I et al (2004) Myocardial ischemia caused by a coronary anomaly. Tex Heart Inst J 31:273–275PubMedPubMedCentralGoogle Scholar
  3. 3.
    Click RL, Holmes DR Jr, Vlietstra RE, Kosinski AS, Kronmal RA (1989) Anomalous coronary arteries: location, degree of atherosclerosis and effects on survival—a report from coronary artery surgery study. J Am Coll Cardiol 13:531–537CrossRefPubMedGoogle Scholar
  4. 4.
    Karur S, Patra S, Shankarappa RK, Agrawal N, Math RS, Nanjappa MC (2013) Percutaneous coronary intervention in patients with anomalous origin of coronary artery presenting with acute coronary syndrome: a case series. J Cardiovasc Dis Res 4:204–208CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Kim SY, Seo JB, Do KH et al (2006) Coronary artery anomalies: classification and ECG-gated multi-detector row CT findings with angiographic correlation. Radiographics 26:317–333CrossRefPubMedGoogle Scholar
  6. 6.
    Mohsen GA, Mohsin KG, Forsberg M, Miller E, Taniuchi M, Klein AJP (2013) Anomalous left circumflex artery from the right coronary cusp: a bening variant? J Invasive Cardiol 25:284–287PubMedGoogle Scholar
  7. 7.
    Nicks R, Cartmill T, Bernstein L (1970) Hypoplasia of the aortic root. Thorax 25:339–346CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Page HL Jr, Engel HJ, Camphell WB, Thomas CS Jr (1974) Anomalous origin of the left circumflex coronary artery. Recognition, angiographic demonstration and clinical significance. Circulation 50:768–773CrossRefPubMedGoogle Scholar
  9. 9.
    Samarendra P, Kumari S, Hafeez M, Vasavada BC, Sacchi TJ (2001) Anomalous circumflex coronary artery: benign or predisposed to selective atherosclerosis. Angiology 52:521–526CrossRefPubMedGoogle Scholar
  10. 10.
    Vaishnava P, Pyo R, Filsoufi F, Sharma S (2011) Compression of an anomalous left circumflex artery after aortic and mitral valve replacement. Ann Thorac Surg 92:1887–1889CrossRefPubMedGoogle Scholar
  11. 11.
    Veinot JP, Acharya VC, Bedard P (1998) Compression of anomalous circumflex coronary artery by a prosthetic valve ring. Ann Thorac Surg 66:2093–2094CrossRefPubMedGoogle Scholar
  12. 12.
    West NE, McKenna CJ, Ormerod O, Forfar JC, Banning AP, Channon KM (2006) Percutaneous coronary intervention with stent deployment in anomalously arising left circumflex coronary arteries. Catheter Cardiovasc Interv 68:882–890CrossRefPubMedGoogle Scholar
  13. 13.
    Wyeth RP, Santo A (2014) Variant aortic sinusal origin of the left circumflex coronary artery. Int J Anat Var 7:109–111Google Scholar
  14. 14.
    Yuan SM (2014) Anomalous origin of coronary artery: taxonomy and clinical implication. Rev Bras Cir Cardiovasc 29:622–629PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • Arpandeep Randhawa
    • 1
  • Abhimanyu Saini
    • 2
  • Anjali Aggarwal
    • 1
    • 5
  • Tulika Gupta
    • 1
  • Uma Nahar Saikia
    • 3
  • Manoj Kumar Rohit
    • 4
  • Daisy Sahni
    • 1
  1. 1.Department of AnatomyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of Internal MedicineJohn H. Stroger Jr. Hospital of Cook CountyChicagoUSA
  3. 3.Department of HistopathologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  4. 4.Department of CardiologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  5. 5.ChandigarhIndia

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