Background: Double blood supply to the anterior descending artery is a rare finding of coronary angiography. However, infective endocarditis (IE) combined with anomalous double blood supply to the anterior descending artery has not been reported.
Case presentation: A 58-year-old male previously diagnosed with IE came to the emergency department with complaints of chest tightness and dyspnea. Further examination confirmed severe aortic valve regurgitation combined with IE and anomalous double blood supply to the anterior descending artery. The cardiopulmonary bypass surgery was performed by direct perfusion through the normal left and right coronary openings. After surgery, the heart started beating again normally without any cardiogenic ischemic events.
Conclusion: Cardiopulmonary bypass by direct perfusion was safe in the patient with anomalous double blood supply to the anterior descending artery.