Publish in this journal
Journal Information
Vol. 68. Issue 5.
Pages 436 (May 2015)
Download PDF
More article options
Vol. 68. Issue 5.
Pages 436 (May 2015)
Image in cardiology
Full text access
Left Main Coronary Artery Atresia in an Asymptomatic Elderly Adult
Agenesia de tronco común izquierdo en anciano asintomático
Belén Rubio Alonsoa,
Corresponding author

Corresponding author:.
, Alfonso Jurado Romána, Sergio Alonso Charterinab
a Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, Spain
Article information
Full Text
Download PDF
Figures (1)
Additional material (2)
Full Text

Coronary artery anomalies are uncommon, with an incidence ranging between 0.2% and 1.4%. Among those least frequently observed is left main coronary artery atresia.

We report the case of a 72-year-old man, with asymptomatic severe aortic stenosis and moderate ventricular dysfunction. He underwent preoperative coronary angiography in which it was not possible to examine the left main coronary artery. Right coronary artery was dominant and the conal branch had an independent origin (Figure A and video 1 of the supplementary material). Blood was delivered to the left coronary tree by way of collateral circulation arising from the conal branch, which was anastomosed to the segment proximal to the anterior descending artery (Figures B and C, asterisks; video 2 of the supplementary material). The anterior descending and circumflex arteries were connected at their origin in the base of a blind pouch (Figure B, arrow head). There was no evidence of significant coronary artery calcification or stenosis.


High-resolution computed tomography was carried out to ensure complete evaluation of the anatomy. Three-dimensional reconstruction revealed left main coronary artery atresia and absence of the left coronary ostium in the left sinus of Valsalva (Figure D, arrow head), and confirmed the normal position of the anterior descending and circumflex arteries. The double-barreled origin of the right coronary artery and the conal branch and their anastomosis to the anterior descending artery were also clearly visualized (Figures E; Figure D, asterisk).

Left main coronary artery atresia was confirmed during valve replacement surgery and, 1 year later, the patient remained asymptomatic and with normal ventricular function.

Copyright © 2014. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?