Congenital Coronary Artery Anomalies: Three Cases and Brief Review of the Literature

Figures

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  Figure 1. CT angiography of the aorta revealing an anomalous origin of the RCA (depicted with an “∗”). The RCA exhibits an interarterial course between the aorta and the pulmonary artery (PA).

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  Figure 2. Coronary angiography confirming the anomalous aortic origin of the RCA from the left coronary sinus. LM: left main.

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  Figure 3. CT coronary angiography with volume-rendered 3D reconstruction of the images, revealing the interarterial course of the RCA (pointed with the arrow) between the aorta and the pulmonary artery (PA).

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  Figure 4. (a, b) Coronary angiography (right anterior oblique projection) revealing the split RCA (marked as RCA1 and RCA2) with an anomalous origin from the left coronary sinus. The RCA and LCA were outlined simultaneously using the JL4 catheter placed at the left coronary sinus. LCx: left circumflex artery; OM: obtuse marginal artery; LAD: left anterior descending (artery).

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  Figure 5. CT angiography of the aorta revealing a short LMCA (a) which then splits into two distinct branches (pointed with arrows of different color) descending toward the apex in the anterior interventricular groove. The short LAD is pointed with blue arrows and the long LAD with red arrows.

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  Figure 6. (a, b) Coronary angiogram: right anterior oblique caudal projection (a) and left anterior oblique caudal “spider” projection (b). A very short LMCA, best visualized in (b), gives rise to the LCx and a common LAD trunk which we denote as LAD-P. The LAD-P bifurcates into two arteries, S-LAD, giving rise to long septal perforators, and L-LAD reaching the apex, giving rise to shorter perforating arteries and diagonals. LAD-P: left anterior descending proper; L-LAD: long LAD; S-LAD: short LAD; LCx: left circumflex artery; S: septal perforating branches.