PMC5902108_01
Axial view of multidetector cardiac CT angiogram shows the origin of the left main coronary artery (LMCA) from the main pulmonary artery (blue arrow).
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fig1
EKG-gated multidetector cardiac computed tomographic angiography revealed the presence of a large anomalous left main coronary arising from the main pulmonary artery (Figure 1).
Sagittal view of multidetector cardiac CT angiogram shows an ectatic and dilated right coronary artery (RCA) (green arrow).
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fig2
The left anterior descending artery, diagonal branch, and left circumflex arteries arising from the left main were ectatic vessels with extensive collateralization with a large ectatic right coronary artery arising from the right aortic coronary sinus (Figure 2).
3D reconstruction image of the heart in the right anterior oblique projection demonstrates severely dilated and tortuous RCA (green arrow) and dilated LMCA (blue arrow) along with large intercoronary collaterals (white arrow).
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fig3
There was evidence of markedly increased color Doppler signaling within the interventricular septum suggestive of high blood flow through septal collaterals (Figures 3 and 4).
3D reconstruction image of the heart in the left anterior oblique projection demonstrates the dilated LMCA and left anterior descending artery (blue arrow) coursing around the left side of the pulmonary artery.
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fig4
There was evidence of markedly increased color Doppler signaling within the interventricular septum suggestive of high blood flow through septal collaterals (Figures 3 and 4).