title: New congenital coronary artery anomaly - double supply of single left anterior descending coronary artery from the left and right coronary sinuses: a case report.
abstract: BACKGROUND
  A normal anatomy of coronary arteries is important to have adequate cardiac muscle blood supply especially during extraneous physical activities. This case report describes a rare coronary anomaly in which the accessory coronary artery arose from the right coronary artery, reentered the left anterior descending coronary artery, and then ran as a single vessel.
  
  
  METHODS
  We present a case of a coronary anomaly in a 47-year-old white man who presented with atypical angina. Computed tomographic angiography and coronary angiography showed a variant of dual left anterior descending coronary artery not previously described. Our patient's accessory coronary artery arose from his right coronary artery. It took an intramuscular course beneath the right ventricular outflow tract in the interventricular septal area to the anterior interventricular sulcus, giving off septal perforators that reentered his medial left anterior descending coronary artery. Both vessels ran after the anastomosis in the anterior interventricular sulcus as a single vessel.
  
  
  CONCLUSIONS
  We propose that this anomaly represents a new variant of coronary artery anomaly. This coronary artery anomaly does not cause ischemia. Recognition of this coronary anomaly is important in patients undergoing percutaneous coronary intervention or coronary artery bypass graft operations.
authors.affiliation: Department of Cardiology, Al Najah National University Hospital, Nablus, West Bank, Palestine. yunis.daralammouri@najah.edu.
authors.forename: Yunis
authors.initials: Y
authors.lastname: Daralammouri
authors.affiliation: Department of Cardiology, Al Najah National University Hospital, Nablus, West Bank, Palestine.
authors.forename: Malik
authors.initials: M
authors.lastname: Ghannam
authors.affiliation: Department of Cardiology, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Germany.
authors.forename: Bernward
authors.initials: B
authors.lastname: Lauer
mesh_terms: D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D054326:Coronary Sinus / Q000000981:diagnostic imaging*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Congenital coronary anomaly; Dual left anterior descending artery distribution