The posterior descending artery can arise from right coronary artery (RCA) in a pattern of right dominance (85% of patients) and co-dominance (7% of patients) or from the left
circumflex artery (LCX) in a pattern of left dominance (8% of patients),3 therefore on ECG it may manifest as ST segment elevations in both the anterior and inferior leads.
The dominant vascular pedicle is normally the terminal branch of the medial femoral
circumflex artery, but on occasion it may arise directly from the profunda femoris artery.
The
circumflex artery contributed to 22.3% of ventricular and myocardial ischemia, which was lower than those of anterior descending branch (41.5%) and right coronary artery (36.2%).
The RCA and
circumflex artery exhibited chronic occlusion.
(5.) Page HL Jr, Engel HJ, Campbell WB, Thomas CS Jr; Anomalous origin of the left
circumflex coronary artery.
MDCT coronary angiography was done on 128-slice CT scanner, which showed absent left
circumflex artery with normal right coronary artery and left anterior descending artery (Fig.
In our case, the left main coronary artery originates from the left coronary sinus which divides into left anterior descending artery and left
circumflex artery.
This was repeated at the aneurysms of the left coronary artery and the
circumflex artery.
Ozdemir, "Anomalous origin of the left
circumflex coronary artery from the right coronary artery and the left anterior descending artery from the right coronary sinus," Journal of Invasive Cardiology, vol.
However, on autopsy, the right coronary and left
circumflex arteries have shown bridging at comparable rates [3].
However, there was a fistula network from the end of the left anterior descending artery and
circumflex arteries to the LV cavity during end-diastole similarly a ventriculography pose (Figure 2).
Coronary angiography was performed; proximal and mid portions of LAD had plaques, mid and distal portions of the
circumflex artery had plaques, distal
circumflex artery was 30% lesion-obstructed, and proximal RCA was 30%-40% lesion-obstructed.