A novel type of dual left anterior descending coronary artery in a patient with acute coronary syndrome/Akut koroner sendromlu bir hastada yeni tip ikili sol on inen koroner arter.

Here we described a new type of dual left anterior descending coronary artery (LAD) anomaly in patient with acute coronary syndrome. A 49-year-old male without cardiac history was admitted to our department with chest pain. Resting twelve-lead electrocardiogram showed sinus rhythm with inverted T waves in the precordial leads. His symptoms were persisted despite the optimal medical therapy then coronary angiography was performed. Coronary angiogram showed dual LAD anomaly. The more prominent LAD arose from aorta with separate ostium above the left main coronary artery. The short LAD arose from the left main coronary artery and ended after 1st septal perforator and 1st diagonal branch (Fig. 1, 2). The long LAD showed 70% stenosis at the proximal segment. The short LAD was a small-caliber vessel with severe stenosis after 1st septal perforator and 1st diagonal branch. The infarct-related artery was the first diagonal branch of the short LAD, which was found totally occluded with Thrombolysis In Myocardial Infarction Flow (TIMI) grade 0 flow (Fig. 1, panel A, arrowhead). Because the vessel was very small and short, we did not perform percutaneous coronary intervention to culprit lesion. One Taxus stent (3.5x20 mm, slow release, polymer based, paclitaxel-eluting Express stent, Boston Scientific, Natick, Massachusetts, USA) was directly implanted to the long LAD lesion successfully. Coronary angiogram after stent implantation showed no residual stenosis (Fig. 2, panel B).

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Isik Erdogan, Tugrul Okay, Gokhan Kahveci [1]

[1] Department of Cardiology, Rize State Hospital, Rize, Turkey

Department of Cardiology, International Hospital, Istanbul

Address for Correspondence/Yazisma Adresi: Uzm. Dr. Gokhan Kahveci Department of Cardiology, Rize State Hospital Islampasa Mah., Sehitler Cad., No:74 53100 Rize, Turkey Phone: [phone] Fax: [phone] E-mail:[e-mail]