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Anomalous left main coronary artery originating from the right sinus of Valsalva: 2 case reports

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Author(s): Anna Kozieradzka

Journal: Polish Journal of Cardiology
ISSN 1507-5540

Volume: 13;
Issue: 2;
Start page: 132;
Date: 2011;
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Keywords: coronary artery anomaly | | |

ABSTRACT
Coronary artery anomalies are a relatively common angiographic finding and constitute one of the major reasons for sudden cardiac deaths in athletes. The highest risk of death is associated with origination of the left main coronary artery (LMCA) from the right sinus of Valsalva and further coursing of the vessel between the aorta and the pulmonary trunk (risk of compression). Recent ACC/AHA guidelines recommend surgical revascularization in every such a patient. We report 2 cases of patients with an ectopic origin of the LMCA, hospitalized recently in our department with a preliminary diagnosis of an acute coronary syndrome. In both of them anomalies were diagnosed based on coronary angiogram. However, in order to determine the detailed course of the vessels computed tomography was needed. The patients presented 2 alternative benign courses of the LMCA: between the aortic root and the right ventricular outflow tract (intraseptal) or between the left atrium and the posterior wall of the aortic bulb (retroaortic). In this manuscript we discuss undertaken diagnostic procedures and patients' management in the context of current guidelines.
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