CTICasesSingle Coronary Artery Variant with Pre-pulmonic Left Main Coronary Artery
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Imaging findings
Computed tomography angiography demonstrates a rare single coronary artery variant arising from the right coronary cusp. The single coronary artery gives off a dominant, wrapping right coronary artery, while an anomalous pre-pulmonic left main coronary artery courses anteriorly over the right ventricular outflow tract and main pulmonary artery to divide into the left anterior descending and circumflex arteries. The conus artery is noted to be absent or extremely small.
Key takeaways
Most coronary anomalies discovered on computed tomography are incidental and asymptomatic. While a single coronary artery variant is rare, the pre-pulmonic course of the anomalous left main artery is generally benign compared to malignant interarterial courses, though accurate depiction of its path remains essential for any future cardiothoracic surgical planning.
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