Hypoplastic Left Anterior Descending Coronary: Early Assessment by Transthoracic Coronary Ultrasound

Main Article Content

Cesare R. Sirtori Samuela Castelnuovo Fabien Labombarda


The presence of a hypoplastic coronary is a relatively rare condition and it is seldom reported. Hypoplastic coronary can lead to severe ischemic consequences and appears to be poorly sensitive to invasive treatment. The case of a patient evaluated by transthoracic echocardiographic ultrasound (TTE-US) of the coronary tree is here reported. A poor visualization of the left anterior descending (LAD) coronary, generally well visible by this technique was noted. A few months later the patient underwent a myocardial infarction (MI) in the LAD territory. The coronary angiogram noted a hypoplastic LAD, poorly expanded by the stent. This finding was confirmed by repeated US,

The potential implication of this case report is that a more frequent use of a coronary TTE-US evaluation may at times indicate the presence of a poorly visible major coronary. The presence of a hypoplastic coronary artery should be considered.

Article Details

How to Cite
SIRTORI, Cesare R.; CASTELNUOVO, Samuela; LABOMBARDA, Fabien. Hypoplastic Left Anterior Descending Coronary: Early Assessment by Transthoracic Coronary Ultrasound. Medical Research Archives, [S.l.], v. 6, n. 2, feb. 2018. ISSN 2375-1924. Available at: <http://journals.ke-i.org/index.php/mra/article/view/1683>. Date accessed: 23 mar. 2018. doi: https://doi.org/10.18103/mra.v6i2.1683.
Research Articles


(1) Labombarda F, Castelnuovo S, Goularas D, Sirtori CR. Status and potential clinical value of a transthoracic evaluation of the coronary arteries. Cardiovasc Ultrasound 2016; 14:5.
(2) Baldassarre D, Hamsten A, Veglia F, de Faire U et al IMPROVE Study Group. Measurements of carotid intima-media thickness and of interadventitia common carotid diameter improve prediction of cardiovascular events: results of the IMPROVE (Carotid Intima Media Thickness [IMT] and IMT-Progression as Predictors of Vascular Events in a High Risk European Population) study. J Am Coll Cardiol 2012; 60(16):1489-1499.
(3) The use of echocardiography for the non-invasive evaluation of coronary artery disease. Sirtori CR, Labombarda F, Castelnuovo S, Perry R. Ann Med 2017; 49:134-141.
(4) Topaz O, De Marchena EJ, Perin E et al. Anomalous coronary arteries: angiographic findings in 80 patients. Int J Cardiol 1992; 34:129-138.
(5) Prashanth P, Mukhaini M. Single right coronary artery continuing as left circumflex artery and hypoplastic left anterior descending artery: a rare coronary anomaly. J Invasive Cardiol 2008; 20: E192-194.
(6) Labombarda F, Coutance G, Pellissier A, Mery-Alexandre C, Roule V, Maragnes P, Milliez P, Saloux E. Major congenital coronary artery anomalies in a paediatric and adult population: a prospective echocardiographic study. Eur Heart J Cardiovasc Imaging 2014; 15(7):761-768.
(7) Perry R, Joseph MX, Chew DP, Aylward PE, De Pasquale CG. Coronary artery wall thickness of the left anterior descending artery using high resolution transthoracic echocardiography--normal range of values. Echocardiography 2013; 30(7):759-764.
(8) Wada T, Hirata K, Shiono Y, Orii M, Shimamura K, Ishibashi K, et al. Coronary flow velocity reserve in three major coronary arteries by transthoracic echocardiography for the functional assessment of coronary artery disease: a comparison with fractional flowreserve. Eur Heart J Cardiovasc Imaging. 2014 Apr;15(4): 399-408.
(9) Al-Lamee R, Thompson D, Dehbi HM, Sen S, et al ORBITA investigators. Percutaneous coronary intervention in stable angina (ORBITA): a double blind, randomized controlled trial. Lancet. 2017 Nov 1. pii: S0140-6736(17)32714-9. doi: 10.1016/S0140-6736(17)32714-9. [Epub ahead of print]

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.