PMC3902410_01
Pre-operative images. (A) Three dimensional volume rendering of contrast-enhanced CT scan shows the anomalous RCA shared the same sinus with the left coronary system, with its attenuated proximal portion passing between the aorta and pulmonary trunk in patient 1. The left coronary system is patent. (B) Coronary angiogram shows anomalous origin of the right coronary artery (black arrowheads) from left sinus of Valsalva, next to the left (white arrowheads) coronary arteries in patient 2. Also it is noted that severe stenotic lesions are present on the RCA. (C) Coronary angiogram in right anterior oblique view shows collateral circulation to the distal RCA (white arrows) via septal branches of the left anterior descending artery, with the normal left coronary artery system in patient 3. (CT: computed tomography; AO: aorta; LMC: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery).
1749-8090-9-21-1.jpg
PMC3902410_03_1749-8090-9-21-1.jpg
F1
Also it showed collateral circulation to the distal RCA via septal branches of LAD (Figure  1C).
Postoperative images. (A) Post-operative enhanced chest CT scan shows neo-ostium (black asterisk) from the right sinus of Valsalva in patient 1. (B) Post-operative contrast-enhanced CT scan shows the anomalous RCA shared the same sinus with the left coronary system (white asterisk), with its attenuated proximal portion passing between the aorta and pulmonary trunk in patient 2. This image also shows that RGEA was bypassed to the distal RCA. (C) Post-operative three-dimensional volume rendering of contrast-enhanced CT scan in patient 3. Chest CT scan revealed that the ascending aorta and part of the aortic arch were replaced with a prosthetic graft, and that the innominate artery was bypassed using a side-arm branch. Also the left internal thoracic artery to the proximal right coronary artery bypass was patent. (CT: computed tomography; AO: aorta; LMC: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery; LITA: right internal thoracic artery; RGEA: right gastroepiploic artery).
1749-8090-9-21-2.jpg
PMC3902410_03_1749-8090-9-21-2.jpg
F2
The ascending aorta and part of the aortic arch were replaced, and the RCA was bypassed by the left ITA with proximal ligation (Figure  2C).
PMC3902410_02
Pre-operative images. (A) Three dimensional volume rendering of contrast-enhanced CT scan shows the anomalous RCA shared the same sinus with the left coronary system, with its attenuated proximal portion passing between the aorta and pulmonary trunk in patient 1. The left coronary system is patent. (B) Coronary angiogram shows anomalous origin of the right coronary artery (black arrowheads) from left sinus of Valsalva, next to the left (white arrowheads) coronary arteries in patient 2. Also it is noted that severe stenotic lesions are present on the RCA. (C) Coronary angiogram in right anterior oblique view shows collateral circulation to the distal RCA (white arrows) via septal branches of the left anterior descending artery, with the normal left coronary artery system in patient 3. (CT: computed tomography; AO: aorta; LMC: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery).
1749-8090-9-21-1.jpg
PMC3902410_03_1749-8090-9-21-1.jpg
F1
Also it showed collateral circulation to the distal RCA via septal branches of LAD (Figure  1C).
Postoperative images. (A) Post-operative enhanced chest CT scan shows neo-ostium (black asterisk) from the right sinus of Valsalva in patient 1. (B) Post-operative contrast-enhanced CT scan shows the anomalous RCA shared the same sinus with the left coronary system (white asterisk), with its attenuated proximal portion passing between the aorta and pulmonary trunk in patient 2. This image also shows that RGEA was bypassed to the distal RCA. (C) Post-operative three-dimensional volume rendering of contrast-enhanced CT scan in patient 3. Chest CT scan revealed that the ascending aorta and part of the aortic arch were replaced with a prosthetic graft, and that the innominate artery was bypassed using a side-arm branch. Also the left internal thoracic artery to the proximal right coronary artery bypass was patent. (CT: computed tomography; AO: aorta; LMC: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery; LITA: right internal thoracic artery; RGEA: right gastroepiploic artery).
1749-8090-9-21-2.jpg
PMC3902410_03_1749-8090-9-21-2.jpg
F2
The ascending aorta and part of the aortic arch were replaced, and the RCA was bypassed by the left ITA with proximal ligation (Figure  2C).
PMC3902410_03
Pre-operative images. (A) Three dimensional volume rendering of contrast-enhanced CT scan shows the anomalous RCA shared the same sinus with the left coronary system, with its attenuated proximal portion passing between the aorta and pulmonary trunk in patient 1. The left coronary system is patent. (B) Coronary angiogram shows anomalous origin of the right coronary artery (black arrowheads) from left sinus of Valsalva, next to the left (white arrowheads) coronary arteries in patient 2. Also it is noted that severe stenotic lesions are present on the RCA. (C) Coronary angiogram in right anterior oblique view shows collateral circulation to the distal RCA (white arrows) via septal branches of the left anterior descending artery, with the normal left coronary artery system in patient 3. (CT: computed tomography; AO: aorta; LMC: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery).
1749-8090-9-21-1.jpg
PMC3902410_03_1749-8090-9-21-1.jpg
F1
Also it showed collateral circulation to the distal RCA via septal branches of LAD (Figure  1C).
Postoperative images. (A) Post-operative enhanced chest CT scan shows neo-ostium (black asterisk) from the right sinus of Valsalva in patient 1. (B) Post-operative contrast-enhanced CT scan shows the anomalous RCA shared the same sinus with the left coronary system (white asterisk), with its attenuated proximal portion passing between the aorta and pulmonary trunk in patient 2. This image also shows that RGEA was bypassed to the distal RCA. (C) Post-operative three-dimensional volume rendering of contrast-enhanced CT scan in patient 3. Chest CT scan revealed that the ascending aorta and part of the aortic arch were replaced with a prosthetic graft, and that the innominate artery was bypassed using a side-arm branch. Also the left internal thoracic artery to the proximal right coronary artery bypass was patent. (CT: computed tomography; AO: aorta; LMC: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery; LITA: right internal thoracic artery; RGEA: right gastroepiploic artery).
1749-8090-9-21-2.jpg
PMC3902410_03_1749-8090-9-21-2.jpg
F2
The ascending aorta and part of the aortic arch were replaced, and the RCA was bypassed by the left ITA with proximal ligation (Figure  2C).