SUCCESSFUL PTCA IN A CASE OF ANOMALOUS ORIGIN OF THE LEFT CIRCUMFLEX CORONARY ARTERY

We experienced a case of anomalous origin of the left circumflex coronary artery (LCX) from the right sinus of Valsalva successfully treated by PTCA. A 48-year-old man had had recurrent exertional chest pain for a year. Physical examination, laboratory tests, electrocardiography, chest X-ray and echocardiography showed no abnormality. Coronary angiographic study revealed anomalous origin of LCX from the right sinus of Valsalva and bilateral coronary artery-pulmonary artery fistula. LCX arising aberrantly from the right sinus of Valsalva showed 90% stenosis in its proximal portion. PTCA to LCX was carried out, and an excellent result was obtained. PTCA is useful even if the coronary artery arises aberrantly from the sinus of Valsalva. This case is very rare in terms of the combined bilateral coronary artery-pulmonary artery fistulas and anomalous origin of coronary artery.