Single Coronary Artery with the Absence of a Left Anterior Descending Artery

Transesophageal echocardiogram depicting atrial septal defect. LA = left atrium; RA = right atrium; ASD = atrial septal defect.
Left anterior oblique view depicting the right coronary artery and left circumflex artery.
Right anterior oblique view showing the left circumflex artery (LCx) coursing anterior to major vessels.
Left anterior oblique view demonstrating the absence of a left anterior descending artery. RCA = right coronary artery; LCx = left circumflex artery.
Left ventriculogram showing the absence of a left anterior descending artery.
Single Coronary Artery with the Absence of a Left Anterior Descending Artery
Single Coronary Artery with the Absence of a Left Anterior Descending Artery
Single Coronary Artery with the Absence of a Left Anterior Descending Artery
Author(s): 

Sanjeev Wasson, MD, Lokesh Tejwani, MD, Rajeev Angampally, MD, Greg Flaker, MD


The interest in our case was sparked by the uniqueness of this anomaly and its implications. The possible mechanisms of symptomatology may include right ventricular overload due to the presence of an atrial septal defect leading to right ventricular enlargement and, consequently, symptoms such as dyspnea. Relief of our patient’s symptoms subsequent to the ASD repair suggests that the simultaneous surgical approach to both the coexisting congenital heart disease like ASD, and the high-risk coronary anomaly, should be recommended to prevent further clinical deterioration and future cardiac events.

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