title: Anomalous origin of the left main coronary artery misdiagnosed by coronary angiography and correctly detected with multidetector computed tomography.
abstract: We describe a case of a very anomalous origin of the left main coronary artery, misdiagnosed as occluded at previous invasive coronary angiography. Multidetector computed tomography coronary angiography demonstrated the vessel to be patent, with an anomalous origin from the commissural region between the right sinus of Valsalva and posterior sinus of Valsalva. A large coronary fistula between proximal left anterior descending coronary artery and the right sinus of Valsalva was also demonstrated. This is an example of the additional clinical role of multidetector computed tomography coronary angiography in comparison to conventional coronary angiography in this clinical field.
authors.affiliation: Centro Cardiologico Monzino, Department of Cardiovascular Sciences, IRCCS, University of Milan, Milan, Italy. daniele.andreini@ccfm.it
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
authors.forename: Antonio
authors.initials: A
authors.lastname: Bartorelli
mesh_terms: D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D012850:Sinus of Valsalva / Q000002:abnormalities / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed