Dual anterior interventricular artery type IV: a rare anatomical variation.
Type IV dual anterior interventricular artery (AIVA) is a rare variant that involves bilateral connection of this vessel to the left main coronary artery and right coronary artery or right aortic sinus. We present a case of such a variant where the ectopic branch traveled an intraseptal course, i.e., through the superior aspect of the crista supraventricularis in a subendocardial position and then intramyocardially inside the upper interventricular septum to reach the anterior interventricular sulcus and descend toward the apex. In a left anterior oblique view, this course lacked the typical caudal anterior loop but it was recognized by virtue of emergence of a septal branch as the first branch of the ectopic AIVA. Recognition of this variant and differentiation among the possible courses of the ectopic branch is important for patient management.
Andreou
Andreas Y
AY
Cardiology Department, Nicosia General Hospital, Old Road Nicosia-Limassol 213, Strovolos, P.O. Box 2029, Nicosia, Cyprus. y.andreas@yahoo.com
Avraamides
Panayiotis C
PC
Georgiou
George M
GM
D000368:Aged; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging