Protective Role of Intercoronary Communication between Right Coronary Artery with Chronic Total Occlusion and Normal Left Circumflex Artery against Recurrent Myocardial Ischemia

Abstract

Intercoronary communication is a very rare congenital malformation, which differs from coronary collaterals in variable aspects. It is larger in diameter, extramural in location and more resembles normal mature arterial features histologically. There are no consensus for the definition of intercoronary communiations, but some reports have suggested their protective role against myocardial ischemia due to its dual blood supply system. We report the case of a 72 year-old male smoker who had chronic total occlusion at the proximal portion of right coronary artery, which was communicated with a normal left circumflex artery. Although the patient had chronic total occlusion and subsequent in stent restenosis, there were no presentations of acute coronary syndrome or myocardial infarction.