PMC8143727_01
Coronary artery angiography demonstrating the anomalous LM origin form the right coronary sinus and the severe atherosclerosis involving the coronary arteries. RCA: Right coronary artery, LMCA: Left main coronary artery, LAD: Left anterior descending artery, CX: Circumflex artery.
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Left heart catheterization demonstrated significant RCA stenosis, with super dominance in distribution pattern (Fig. 1).
A: Coronary Computed Tomography (Posterior View): This figure illustrates the anomalous origin of the left main coronary artery from the opposite sinus and the retroaortic course as well as the severe atherosclerotic disease involving the left main and right coronary arteries. A: Pulmonary Artery, B: Aortic Root, C: Left Main Coronary Artery, D: Right Coronary Artery. Fig. 2B: Coronary Computed Tomography (Anterior View) demonstrating the termination of the left Main Coronary Artery with small terminal branches. A: Right Atrium, B: Aortic Root, C: Pulmonary artery, D: Left Main Coronary Artery, E: Left Anterior.
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Circumflex arteries. Coronary Computed Tomography (CT) for better assessment of the anatomy was performed and showed anomalous LM coronary artery arising from the opposite sinus and courses posterior to the aortic root with significant stenosis (Fig. 2A), then branching on the anterior and lateral surfaces of the heart with significant stenosis and small quality LAD and circumflex arteries (Fig. 2B).