PMC5745736_01
Presentation of anomalous circumflex course. Arrows and color-Doppler indicate its course.
CRIC2017-9249821.001.jpg
PMC5745736_01_CRIC2017-9249821.001.jpg
fig1
Furthermore, on the basis of a "crossed aorta sign," we suspected the anomalous circumflex (Cx) coronary artery with probable origin from the right sinus of Valsalva (Figure 1).
(a-b) Presentation of retroaortic course of circumflex coronary, suggesting "crossed aorta sign" in a modified apical four-chamber view behind left atrium during transthoracic study (arrows).
CRIC2017-9249821.002.jpg
PMC5745736_01_CRIC2017-9249821.002.jpg
fig2
In a five-chamber apical view, Cx seemed to cross the aorta perpendicularly to aortic long axis, suggesting retroaortic course (Figures 2(a) and 2(b)), as previously described by Wierzbowska and colleagues.
(a-b) Angiographic view of the anomalous circumflex origin from right Valsava sinus (arrows).
CRIC2017-9249821.003.jpg
PMC5745736_01_CRIC2017-9249821.003.jpg
fig3
During angiography, the anomalous Cx origin from the right sinus was confirmed (Figures 3(a) and 3(b)).