Two cases of anomalous origin of LAD from right coronary artery requiring coronary artery bypass

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Abstract
We experienced two cases with anomalous origin of the left anterior descending artery (LAD) from the proximal right coronary artery requiring coronary artery bypass grafting. A 66-yr old female with a long history of angina and a positive stress test had the anomalous artery coursing anterior to the right ventricular outflow tract. A 42-yr old male with worsening angina after an anteroseptal myocardial infarction had the anomalous artery running between the great vessels. Both patients underwent left internal mammary artery-to-LAD bypass on the beating heart with complete resolution of ischemic symptoms. Isolated coronary artery anomaly is an uncommon disease (0.6–1.2%) in patients undergoing cardiac catheterization and . An anomalous origin of the LAD from the proximal right coronary artery (RCA) or the right sinus of Valsalva (RSV) is very rare, found in 1.2–6.1% of all coronary anomalies and . This coronary anomaly has been considered potentially serious but functionally unimportant [2] . We report two cases of anomalous LAD from the proximal RCA resulting in anterior wall ischemia which was effectively treated by coronary artery bypass surgery.

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