Diagnosis and Operation for Anomalous Circumflex Coronary Artery

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Diagnosis and Operation for Anomalous Circumflex Coronary Artery Keishi Ueyama, MD, PhD, Mahesh Ramchandani, MD, Arthur C Beall, MD, James W Jones, MD, PhD The Annals of Thoracic Surgery Volume 63, Issue 2, Pages 377-381 (February 1997) DOI: 10.1016/S0003-4975(96)00766-7

Fig. 1 Left ventriculography of the right anterior oblique projection shows the anomalous circumflex coronary artery in profile. This anomalous circumflex coronary artery is located posteriorly behind the right sinus of Valsalva and is called the aortic root sign. The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)

Fig. 2 During selective opacification of the left coronary artery in the right anterior oblique projection, one sees a large area of nonperfused myocardium between the coronary artery and the posterior lateral cardiac border. This is called the nonperfused myocardium sign. The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)

Fig. 3 Coronary disease of the anomalous circumflex artery. In (A), the right coronary artery was also diseased. In (B), the left anterior descending coronary artery was opacified through the collateral artery. The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)

Fig. 3 Coronary disease of the anomalous circumflex artery. In (A), the right coronary artery was also diseased. In (B), the left anterior descending coronary artery was opacified through the collateral artery. The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)

Fig. 4 Radiographic diameter of the anomalous circumflex coronary artery. Eighty percent (32/40) of these vessels were more than 2 mm before entering the atrioventricular groove. However, after exiting the atrioventricular groove, 70% (28/40) of these vessels were less than 1.5 mm. The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)

Fig. 5 Approach to the proximal site of the anomalous circumflex coronary artery (ACCA). (IVC = inferior vena cava; RA = right atrium; RCA = right coronary artery; SVC = superior vena cava.) The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)

Fig. 6 Bypass grafting to the proximal site of the anomalous circumflex coronary artery. The Annals of Thoracic Surgery 1997 63, 377-381DOI: (10.1016/S0003-4975(96)00766-7)