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

Case Study A08-1: LCx from Distal RCA via AV Groove

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LCA_RAO 25 Cran 37
Two size 2 diagonal branches supplying anterior and ALM territories. Prominent mid LAD septal but no circumflex.

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RCA_LAO 36 Caud 2
RCA continues well along AV groove giving of two IL and AL marginal branches.

Anatomy – In common large right dominant systems, the RCA supplies 33% and the LCx supplies 18% of the LV myocardium. The RCA can extend its regional supply even further along the left AV groove to, and even including, the LAD distribution.  In the current anomaly, the RCA AV groove segment extends around the obtuse margin to supply modest sized branches to the Anterolateral Marginal segments in addition to the Inferolateral Marginal segments.

Construction – (Select Settings > Choose Button Q Nums.) Template button Q6.4.4.2 in a Right Dominant setting provides for this configuraion. Right-clicking the proximal LCx segment allows you to select “Small/absent”.

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