Heart, Lung and Circulation
Image| Volume 19, ISSUE 2, P96, February 2010

Left Main Coronary Artery Atresia Diagnosed with 128-MDCT

      A 61-year-old female with intermittent chest discomfort and an inconclusive exercise treadmill test was submitted for a non-invasive coronary angiography with 128-multidetector computed tomography (MDCT) with prospective triggering (1.7 mSv). The coronary arteries were free of atherosclerotic coronary artery disease (CAD). However, MDCT clearly demonstrated a congenital anomaly of the coronary arteries, with absence of the left coronary ostium and left main trunk (black arrow). A dominant right coronary artery (RCA) provided blood supply via conus branch (white arrow) to the left anterior descending (LAD) and left circumflex (Cx) arteries, which were located at their normal position. The conus branch (white arrow) coursed anteriorly to the main pulmonary artery. Subsequent invasive coronary angiography confirmed the MDCT findings.
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