Objective: Dual left anterior descending coronary artery (LAD) is a rare congenital anomaly with four subtypes. This anomaly has been described in the angiographic literature, but with the increasing use of coronary CT, it becomes imperative for CT interpreters to be aware of this entity, its implications, and the cross-sectional findings. We report the ECG-gated 64-MDCT coronary angiographic findings on two types of dual LAD (types 1 and 4). The imaging findings of the other types of dual LAD also are discussed.
Conclusion: It is important for CT interpreters to be aware of and recognize dual LAD at coronary CT. Because of inability to visualize the additional vessel, especially when the long LAD originates from the right coronary sinus, the variant anatomic features can be misinterpreted at routine coronary angiography for mid-LAD occlusion. Identification of an additional LAD can be important for diagnosis and therapeutic planning.