Cardiology Research and Practice

Case Report

A Rare Coincidence of Two Coronary Anomalies in an Adult

Figure 1

Transseptal course of the right-sided left main coronary artery by CTA and selective coronary angiography.
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(a) Axial maximum intensity projection at the level of the origin of the LMCA (small arrow) from a common ostium with the right coronary artery (large arrow)
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(b) Demonstration of the course of the LMCA below the pulmonary artery and through the septum by sagittal maximum intensity projection (left) and curved multiplanar reconstruction (right). Left main Coronary artery (white arrow)
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(c) Right anterior oblique showing the LMCA (black arrow) arising with the right coronary artery (white arrow) from a common ostium in the right sinus of Valsalva
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(d) Left lateral projection during selective coronary angiography demonstrating the LMCA dividing into a small caliber LADCA and the left circumflex artery in a 90-degree angle, with the LADCA traveling anteriorly (white arrow), and the left circumflex following its usual distribution posteriorly (black arrow)