Staged Operation for Coronary Artery Disease and Abdominal Aortic Aneurysm Complicated with Congenital Dual left Anterior Descending Coronary Artery

A dual left anterior descending artery is an extremely rare congenital coronary anomaly that has no clinical significance unless superimposed with atherosclerotic coronary artery disease. We describe a 71-year-old Caucasian male with a dual left anterior descending artery who presented with angina pectoris and a gradually expanding abdominal aortic aneurysm. Coronary angiography revealed a Type 3 dual left anterior descending coronary artery and three-vessel disease with left main trunk stenosis. We initially treated the abdominal aortic aneurysm by endovascular aortic aneurysm repair because it had expanded by about 5 mm during short period. Two weeks later, the patient underwent a coronary artery bypass graft. This rare coronary artery anomaly is clinically important from the viewpoint of myocardial revascularization.