SIGNIFICANCE OF ANGIOGRAPHIC ABSENCE OF LEFT ANTERIOR DESCENDING CORONARY ARTERY IN A LEFT VENTRICLE WITH INTACT ANTERIOR WALL.

Fifteen patients having total occlusion of the proximal left anterior descending coronary artery were studied. All fifteen had normal left ventricular anterior walls. The electrocardiogram was normal in eight patients; old inferior wall infarction was evident in one; anterior ischemia in five; and left anterior hemiblock in one. Collateral circulation was found in twelve patients (80%). These findings suggest that an angiographically non-visualized left anterior descending (LAD) vessel is patent and bypassable in patients where the anterior ventricular wall is intact, thus representing an additional criterion for aortocoronary bypass surgery.