Ponytail Left Anterior Descending Artery: A Case Report

Division of the anterior descending branch into many small arteries is a rare coronary anomaly. We report the case of a 64-year-old female with severe stenosis (>75%) in the proximal region of the anterior descending branch as indicated by coronary computed tomography angiography (CCTA). In addition, coronary angiography showed that the anterior descending branch of the coronary artery split into numerous small arteries, an anomaly that can confound clinical examination.

Keywords:
Coronary Vessel Anomalies; Pathologic Construction; Coronary Angiography; Computed Tomography Angiography

Authorship

Rongchuan Yue

conception or design of the work

acquisition

analysis

interpretation of data for the work

final approval of the version

Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.Affiliated Hospital of North Sichuan Medical CollegeChinaNanchong, Sichuan, ChinaDepartment of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

Zaiyong Zheng Zaiyong Zheng Department of Cardiology, The Affiliated Hospital of Southwest Medical University, No.1 Section 1, Xiang Lin Road, Longmatan District, Luzhou City, Sichuan Province, China Zip code: 646000 E-mail: z986100078@outlook.com

conception or design of the work

acquisition

analysis

interpretation of data for the work

final approval of the version

Nucleic Acid Medicine of Luzhou Key Laboratory, Luzhou, Sichuan, China.Nucleic Acid Medicine of Luzhou Key LaboratoryChinaLuzhou, Sichuan, ChinaNucleic Acid Medicine of Luzhou Key Laboratory, Luzhou, Sichuan, China.

Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.Affiliated Hospital of Southwest Medical UniversityChinaLuzhou, Sichuan, ChinaDepartment of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

https://orcid.org/0000-0003-4731-1829

Zhan Lv

conception or design of the work

acquisition

analysis

interpretation of data for the work

final approval of the version

Jie Feng

conception or design of the work

acquisition

analysis

interpretation of data for the work

final approval of the version

Houxiang Hu

conception or design of the work

acquisition

analysis

interpretation of data for the work

final approval of the version

Zaiyong Zheng Department of Cardiology, The Affiliated Hospital of Southwest Medical University, No.1 Section 1, Xiang Lin Road, Longmatan District, Luzhou City, Sichuan Province, China Zip code: 646000 E-mail: z986100078@outlook.com

This study was carried out at the Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

No conflict of interest.

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (6)

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Fig. S1
The twelve-lead ECG on admission showed T-wave inversion in leads V3-5.

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Fig. 1
CCTA imaging (A-B) and three-dimensional reconstruction (C) revealed severe stenosis (>75%) at the proximal region of the anterior descending branch.

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Fig. 2
A-C show three sample images captured with the C-arm oriented at the anterior descending branch view at 30 degrees (RAO30) and CAU30. The images show the anterior descending branch divided into several small arteries.

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Video 1-4
Images were captured with the C-arm oriented at the anterior descending branch at “ponytail” anterior descending branch view with different angles.

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Video 5
Images were captured with the C-arm oriented at the right coronary artery view, LAO45°.

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Fig. 3
The anterior descending branch is divided into many small arteries from the left main coronary. RCA=Right coronary artery; LM=Left main coronary; LCX=Left circumflex branch; LAD=Left anterior descending

Fig. S1 The twelve-lead ECG on admission showed T-wave inversion in leads V3-5.

Fig. 1 CCTA imaging (A-B) and three-dimensional reconstruction (C) revealed severe stenosis (>75%) at the proximal region of the anterior descending branch.

Fig. 2 A-C show three sample images captured with the C-arm oriented at the anterior descending branch view at 30 degrees (RAO30) and CAU30. The images show the anterior descending branch divided into several small arteries.

Video 1-4 Images were captured with the C-arm oriented at the anterior descending branch at “ponytail” anterior descending branch view with different angles.

Link 1: https://s3.sa-east-1.amazonaws.com/publisher.gn1.com.br/bjcvs.org/videos/Video-1.avi Link 2: https://s3.sa-east-1.amazonaws.com/publisher.gn1.com.br/bjcvs.org/videos/Video-2.avi Link 3: https://s3.sa-east-1.amazonaws.com/publisher.gn1.com.br/bjcvs.org/videos/Video-3.avi Link 4: https://s3.sa-east-1.amazonaws.com/publisher.gn1.com.br/bjcvs.org/videos/Video-4.avi

Video 5 Images were captured with the C-arm oriented at the right coronary artery view, LAO45°.

Link: https://s3.sa-east-1.amazonaws.com/publisher.gn1.com.br/bjcvs.org/videos/Video-5.avi

Fig. 3 The anterior descending branch is divided into many small arteries from the left main coronary. RCA=Right coronary artery; LM=Left main coronary; LCX=Left circumflex branch; LAD=Left anterior descending

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Ponytail Left Anterior Descending Artery: A Case Report

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[1] Zaiyong Zheng Department of Cardiology, The Affiliated Hospital of Southwest Medical University, No.1 Section 1, Xiang Lin Road, Longmatan District, Luzhou City, Sichuan Province, China Zip code: 646000 E-mail: z986100078@outlook.com