Coronary anomaly: anomalous right coronary artery originates from the left sinus of Valsalva and coursing between the pulmonary artery and aorta
A 64-year-old woman complained of gradually progressive exertional angina pectoris for 3 months. Electrocardiogram was normal. Coronary angiogram was performed through a trans-radial approach. Coronary angiogram demonstrated the left main coronary artery (LMCA) and LAD were normal, but there was mild stenosis in the middle of the LCX segment (). Repeated attempts to cannulate the RCA were not successful (). A nonselective injection into the left coronary sinus with a pigtail catheter demonstrated an anomalous RCA arising from the left sinus. In order to confirm the anomalous origin and course of RCA, a 64-slice MSCT detection of the heart was performed on a 64-slice machine (Philips 64 Slice, Philips, Amsterdam, The Netherlands). The results showed the anomalous RCA originating from the left sinus of Valsalva, anteriorly, then taking an acute bend to course between the aorta and pulmonary artery trunk. The anomalous RCA was classified as type L-II B subtype ( and ). The patient was treated medically.