Intercoronary communication between left anterior descending artery and totally occluded right coronary artery.

The author presents a patient with chronic total occlusion of the right coronary artery with a large lumen communication to the distal left anterior descending artery as a single conduit. The diameter of this connection was very large and equaled the distal left anterior descending artery diameter. The unusual finding of a large lumen connection between the left anterior descending artery and right coronary artery most likely represents a congenital coronary anomaly.