PMC3877608_01
(a) Cardiac CT angiography with 3D reconstruction with digital subtraction of pulmonary arteries. (b) Cardiac CT angiography.
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fig1
Cardiac CT angiography with 3D reconstruction (Figures 1(a) and 1(b)) showed an anomalous origin of the right coronary artery coursing from the left main coronary artery between the aorta and pulmonary trunk.
(a) Anomalous right coronary artery AP caudal projection with nonselective left coronary ostia angiogram. (b) Anomalous right coronary takeoff from left coronary artery in a RAO caudal projection of nonselective left coronary ostia angiogram. (c) Aortogram utilizing the JR4 catheter showing no separate right coronary ostium.
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fig2
Left heart catheterization and angiography showed an 80% long tubular stenosis of the proximal to mid left anterior descending coronary artery (LAD) as well as an anomalous takeoff of the right coronary artery (RCA) from a left main coronary artery (Figures 2(a), 2(b), and 2(c)).