Chernet B. Tessema* and Nicholas A. Devine
Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, USA
*Correspondence to: Dr. Chernet B. Tessema, Associate Professor, Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, USA
Received: Sep 08, 2026; Accepted: Sep 14, 2026; Published: Sep 21, 2026
Citation: Tessema CB, Devine NA (2026) Unusual Coexistence of Type II Bovine Aortic Arch, Left Dominant Coronary Artery, and Tunneled Left Circumflex Artery in Single Donor Who Had Double CABG. J Anatomical Variation and Clinical Case Report 4:128. DOI: https://doi.org/10.61309/javccr.1000128
Copyright: ©2026 Tessema CB. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ABSTRACT
Anatomy This case report presents an incidental finding in a 90-year-old male donor of the unusual coexistence of three variations: a type II bovine aortic arch, a left-dominant coronary artery, and a tunneled left circumflex artery. The donor had indicators of prior double coronary artery bypass grafts and had a listed cause of death of head injury caused by a motor vehicle accident. Many studies have shown that bovine aortic arch, coronary artery dominance, and tunneled coronary artery variants do not cause clinical symptoms but are risk factors for cardiovascular and neurological diseases. The combined presence of these risk factors around a single heart might further increase the risk of developing associated diseases requiring interventions, including coronary artery bypass grafting, as seen in this donor, to improve coronary circulation. Therefore, knowledge of such variations, which can be associated with significant life-threatening conditions, is vital for the prevention, early diagnosis, and management of the consequent diseases.
Keywords: Coronary artery; Coronary artery bypass graft; Left coronary artery dominance; Type II bovine aortic arch; Tunneled left circumflex artery
Figure 1: Intra-cadaveric view of the type II bovine aortic arch (BAA), showing the left common carotid artery (LCCA) originating from the brachiocephalic trunk (BCT). The figure also illustrates the left internal thoracic-to-left anterior descending artery (LITA-to-LADA) and a portion of the ascending aorta-to-posterior descending (AsA-to-PDA) bypass grafts.
