title: Separate origin of left anterior descending artery and left circumflex artery from left aortic sinus of Valsalva: visualization by multislice computed tomography before and after coronary artery bypass graft.
abstract: A 59-year-old woman was admitted to our hospital because of atypical chest pain. Stress ECG test was inconclusive. The patient underwent contrast-enhanced 16-slice computed tomography which demonstrated the absence of left main, and separate but adjacent ostia of the left anterior descending artery (LAD) and the left circumflex artery (CX) from the left coronary aortic sinus of Valsalva and severe narrowing of their proximal tracts. Conventional coronary angiography confirmed the diagnosis. Some time later, the patient underwent coronary artery bypass graft by left internal mammary artery graft to the LAD and Y-saphenous vein bypass to the obtuse marginal branch of CX. Multislice computed tomography (MSCT) scan, 1 year later, revealed the patency of grafts. MSCT, with the aid of postprocessing techniques, is an accurate and precise, noninvasive tool for the visualization of coronary artery anatomy, identification of coronary stenoses and evaluation of coronary artery bypass grafts.
authors.affiliation: Cardiology Unit, 'San Gennaro' Hospital, A.S.L. Napoli 1, Naples, Italy. carlo.tedeschi@hotmail.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Tedeschi
authors.forename: Roberto
authors.initials: R
authors.lastname: De Rosa
authors.forename: Mario
authors.initials: M
authors.lastname: Garofalo
authors.forename: Gennaro
authors.initials: G
authors.lastname: Ratti
authors.forename: Francesco
authors.initials: F
authors.lastname: Borrelli
authors.forename: Gregorio
authors.initials: G
authors.lastname: Covino
authors.forename: Valentina
authors.initials: V
authors.lastname: Silvestri
authors.forename: Paolo
authors.initials: P
authors.lastname: Capogrosso
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D011237:Predictive Value of Tests; D012850:Sinus of Valsalva / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency