CARAT Case Studies: Coronary Artery Variants and Anomalies (CAVA)

Case Study A06-3: LCx and distal LAD from RCA

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LCA – LAO Cranial
Pair of size 2 diagonal branches to basal and mid anterior and mid ALM LV segments; large SP 1.

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LCA – RAO Cranial

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RCA – LAO Cranial
Posterior IV groove - small PDA with AM branch to dPDA and apex; anomalous LCx and LAD branch pathways obvious.

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RCA - RAO
Large PL branch to apical lateral segment; retro-aortic LCx course; and anterior PA course of distal LAD.

Anatomy – The anomalous LCx passes behind the aorta to supply only a portion of the basal ALM segment. The PL RCA branch is dominant supplying the ILM segments and the apical lateral segment. The anomalous distal LAD is small with the AM RCA branch supplying the apex.

Construction – (Select Settings > Choose Button Q Nums.) Template button options Q1.6 and Q3.1.A.9 set the stage for the LAD and LCx anomalous branches.  The adjustment needed along the posterior interventricular groove was accomplished by selecting the “small” option for the PDA and the “To dPDA and apex” option for the AM branch of the RCA.

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