PMC2244609_01
X-Ray coronary angiography shows the retrograde filling of an anomalous left circumflex artery (LCX) though collateral vessels provided by (a) the left anterior descending artery (LAD) and (b) the right coronary artery (RCA).
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F1
Coronary angiography showed a normal left anterior descending coronary artery (LAD), while the LCX was filled retrogradely by collateral flow through the LAD (figure 1a). The right coronary artery (RCA) arose in typical position and also provided retrograde filling of the LCX (figure 1b).
Multi-planar reformatted CMR images depict the exact origin of (a) the anomalous LCX from the right pulmonary artery and confirm the normal origin and course of (b) the LAD and RCA.
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F2
Thus, CMR provided the exact anatomical depiction of the origin of the anomalous LCX (solid arrow, figure 2a) from the right pulmonary artery (hatched arrow, figure 2a) and demonstrated the normal origin of the LAD and RCA (figure 2b). The patient was then referred for cardiac surgery.