Double right coronary artery in an elderly patient

Abstract

Coronary artery anomalies are encountered in less than 1% of patients undergoing coronary angiography. Among these, double right coronary artery (RCA) is extremely uncommon, and to our knowledge, only nine cases have been reported. A 73-year-old man was admitted with acute anterior myocardial infarction. Coronary angiography revealed TIMI 2 flow in the left anterior descending coronary artery distal to a severe proximal stenosis (90%). The circumflex artery was normal. The right coronary arteriography demonstrated double RCA without an atherosclerotic lesion, each arising from a separate ostium. Both coursed along the atrioventricular groove and terminated by giving off individual posterior descending arteries. The patient underwent emergent coronary bypass surgery and recovered within a week.