Sharing is caring: two coronary arteries sharing a single right coronary ostium in an adult patient with repaired tetralogy of Fallot

Le résumé fourni par la source

A 43-year-old man with repaired tetralogy of Fallot presented with chest pain. His electrocardiogram revealed sinus rhythm with non-specific ST-T wave changes, and a nuclear stress test was negative for ischaemia. Transthoracic echocardiography in the parasternal short-axis view at the level of the aortic cusp (AC) revealed that the left main coronary artery (LMCA) and right coronary artery (RCA) shared a single ostium (Panel A). Cardiac computed tomographic angiography (CTA) confirmed the diagnosis and further delineated the course of the coronary branches (Panels B–D). In the short-axis view at the level of the AC, a solitary coronary artery gave rise to the RCA, a diminutive middle branch, and a long LMCA (Panel B). Volume-rendered three-dimensional reconstruction of the heart and great vessels demonstrated a single coronary ostium branching off the RCA (Panel C) as well as the LMCA, which coursed anterior to the right ventricular outflow tract and gave rise to the left anterior descending (LAD) artery and left circumflex coronary (LCX) artery (Panel D).

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