An unusual right ventricular branch from left anterior descending artery.
Dr Chavali Praveen, DNB Cardiothoracic surgery, Dr Sanjeeva Rao, MCH Cardiothoracic surgery.
Institutional affiliations - Department of CTVS, Usha Mullapudi Cardiac centre, Hyderabad.
Running title- RV branch of LAD
Funding - This study has not been funded by any party whatsoever.
Conflict of interest - Both authors have no conflict of interest.
Corresponding author address- Dr Chavali Praveen, Tower 9 / 112, Provident Kenworth, Rajendranagar, Hyderabad, Telangana, India, Pin Code- 500030.
E Mail ID - prav10@gmail.com
Phone number - +91-9533778067
ORCID ID- ORCID - 0000-0002-2105-3529
IRB approval – N/A (not applicable)
Consent statement – N/A
Clinical trial registration – N/A
A 39 years old male was taken up for cortonary artery bypass grafting for triple vessel coronary artery disease. His preoperative coronary angiogram revealed chronic total occlusion of proximal left anterior descending artery (LAD) with mid and distal LAD faintly filling up by collaterals from right coronary artery. Intra-opratively while exposing the LAD, an unusual epicardial coronary branch was identified originating from it and coursing towards right ventricle, opposite to the diagonal branch of LAD (figure). Left internal mammary artery was anastamosed to LAD. Patient had an uneventful intra and post-operative stay and was discharged in a stable condition with no regional wall motion abnormalities and normal ejection fraction.
Though it has been mentioned that a couple of small right ventricular branches also arise from the LAD supplying small parts of the anterior right ventricle (1) but no such surgical image has been published in literature in the past.
Figure Legend : Unusual RV branch from LAD