Case Reports: Combined congenital coronary artery anomaly: dual left anterior descending coronary artery and absence of left circumflex artery

Because coronary artery anomalies are usually asymptomatic, their incidence is not exactly known in normal population. However, the putative incidence of coronary anomalies was between 0.6-1.3 percent in general population, which had been estimated in coronary angiography series (1, 2). The coincidence of two coronary anomalies is uncommon. In this report, we defined combined coronary anomaly, which consisted of both dual left anterior descending (LAD) coronary artery and absence of left circumflex (Cx) artery in the same patient. The frequency of the absence of the left circumflex artery is reported as 0.003% (4/126.595 cases) in coronary angiography studies. In this case, the super dominance of the right coronary artery (RCA) is seen. Right coronary artery (RCA) super dominance associated with various syndromes has been reported (2, 3). The combination of these two rare coronary anomalies is unusual. We could not found any reports in the literature describing the coincidence of these two coronary anomalies.