Exceptional origin of left anterior descending artery from right sinus of Valsalva

Abstract

A 61-yo pt presented with atypical chest pain. Echocardiography showed inferior wall akinesia. Coronary angiography demonstrated anomalous origin of the left anterior descending artery (LAD), originating from the right coronary sinus, with an intermediate lesion in its middle part. To better define the relationship of the LAD with respect to the aorta, a coronary CT-scan was carried out revealing the anomalous retro-aortic position of LAD, without compression, and without high acute take-off. This variant of LAD arising from the RSV is very rare and data are lacking on its prognostic significance, it is extremely important to assess its course by coronary CT.