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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Circumaortic Configuration of the Left Coronary Arteries

Damandeep Singh1, Niraj Nirmal Pandey1, Vineeta Ojha1

  • 1Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi-110029, India.

Methodist Debakey Cardiovascular Journal
|August 1, 2026
PubMed

Insights

This case study details an extremely rare coronary artery anomaly. Coronary computed tomography angiography is crucial for accurate diagnosis and guiding treatment for complex coronary artery variations.

Area of Science:

  • Cardiovascular Medicine
  • Anatomical Pathology
  • Medical Imaging

Background:

  • Coronary artery anomalies encompass variations in origin, course, and termination.
  • The simultaneous occurrence of a retroaortic left circumflex artery and an interarterial left anterior descending artery originating from the right sinus is exceptionally rare.

Purpose of the Study:

  • To report a rare case of complex coronary artery anomaly.
  • To emphasize the diagnostic utility of coronary computed tomography angiography (CCTA) in such cases.

Main Methods:

  • A detailed case report of a patient with a rare coronary artery anomaly.
  • Coronary computed tomography angiography (CCTA) was utilized for detailed anatomical visualization.

Main Results:

  • The CCTA successfully identified the coexistence of anomalous left circumflex artery with retroaortic course and anomalous left anterior descending artery arising from the right coronary sinus with interarterial course.
  • Conventional catheter angiography posed significant technical challenges and risk of misdiagnosis.

Conclusions:

  • This rare coronary artery anomaly presents diagnostic challenges with conventional angiography.
  • Coronary computed tomography angiography (CCTA) is essential for accurate identification and pre-procedural planning for complex coronary artery anomalies.

Keywords:
coronary artery anomaliescoronary computed tomography angiographyinterarterial courseretroaortic course

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