Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract

An anomalous origin of the left main coronary artery arising from the left ventricular outflow tract is an exceedingly rare congenital coronary anomaly, typically associated with impaired myocardial perfusion. Here, we report the case of a 67-year-old asymptomatic woman in whom an anomalous origin o...

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Main Authors: Huynh Thi Minh Thuy, Tran Minh Bao Luan, Pham Tho Tuan Anh, Nguyen Hoang Dinh
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1640534/full
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author Huynh Thi Minh Thuy
Huynh Thi Minh Thuy
Tran Minh Bao Luan
Tran Minh Bao Luan
Pham Tho Tuan Anh
Nguyen Hoang Dinh
author_facet Huynh Thi Minh Thuy
Huynh Thi Minh Thuy
Tran Minh Bao Luan
Tran Minh Bao Luan
Pham Tho Tuan Anh
Nguyen Hoang Dinh
author_sort Huynh Thi Minh Thuy
collection DOAJ
description An anomalous origin of the left main coronary artery arising from the left ventricular outflow tract is an exceedingly rare congenital coronary anomaly, typically associated with impaired myocardial perfusion. Here, we report the case of a 67-year-old asymptomatic woman in whom an anomalous origin of the left main coronary artery, arising from the left ventricular outflow tract below the aortic valve, was incidentally identified during routine preoperative cardiac evaluation. Despite the anatomical abnormality, the patient exhibited no clinical or imaging evidence of myocardial ischemia. This finding is likely explained by a marked dilation of the right coronary artery and the presence of well-developed collateral circulation supplying the left coronary system. With no evidence of ischemia and maintained ventricular function, a non-interventional approach was deemed appropriate. This case highlights the importance of comprehensive anatomical and functional assessment in detecting clinically silent coronary anomalies and underscores the value of advanced cardiac imaging in the preoperative evaluation of elderly patients undergoing non-cardiac procedures.
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series Frontiers in Cardiovascular Medicine
spelling doaj-art-0e52df69bb4c4cfa9e056c8b63a6a59e2025-08-20T03:38:55ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.16405341640534Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tractHuynh Thi Minh Thuy0Huynh Thi Minh Thuy1Tran Minh Bao Luan2Tran Minh Bao Luan3Pham Tho Tuan Anh4Nguyen Hoang Dinh5Diagnostic Imaging Center, Tam Anh General Hospital, Ho Chi Minh City, VietnamDepartment of Cardiovascular and Thoracic Surgery, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamDepartment of Cardiovascular and Thoracic Surgery, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamThoracic and Vascular Surgery Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VietnamThoracic and Vascular Surgery Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VietnamDepartment of Cardiovascular and Thoracic Surgery, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamAn anomalous origin of the left main coronary artery arising from the left ventricular outflow tract is an exceedingly rare congenital coronary anomaly, typically associated with impaired myocardial perfusion. Here, we report the case of a 67-year-old asymptomatic woman in whom an anomalous origin of the left main coronary artery, arising from the left ventricular outflow tract below the aortic valve, was incidentally identified during routine preoperative cardiac evaluation. Despite the anatomical abnormality, the patient exhibited no clinical or imaging evidence of myocardial ischemia. This finding is likely explained by a marked dilation of the right coronary artery and the presence of well-developed collateral circulation supplying the left coronary system. With no evidence of ischemia and maintained ventricular function, a non-interventional approach was deemed appropriate. This case highlights the importance of comprehensive anatomical and functional assessment in detecting clinically silent coronary anomalies and underscores the value of advanced cardiac imaging in the preoperative evaluation of elderly patients undergoing non-cardiac procedures.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1640534/fullcongenital coronary arteryleft main coronary arteryanomalous origin of the coronary arterycoronary computed tomography angiographycoronary angiography
spellingShingle Huynh Thi Minh Thuy
Huynh Thi Minh Thuy
Tran Minh Bao Luan
Tran Minh Bao Luan
Pham Tho Tuan Anh
Nguyen Hoang Dinh
Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
Frontiers in Cardiovascular Medicine
congenital coronary artery
left main coronary artery
anomalous origin of the coronary artery
coronary computed tomography angiography
coronary angiography
title Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
title_full Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
title_fullStr Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
title_full_unstemmed Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
title_short Case Report: Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
title_sort case report anomalous origin of the left main coronary artery arising from the left ventricular outflow tract
topic congenital coronary artery
left main coronary artery
anomalous origin of the coronary artery
coronary computed tomography angiography
coronary angiography
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1640534/full
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