Congenital Absence of Left Circumflex Coronary Artery: Role of Computed Tomography Coronary Angiography

Abstract

Congenital coronary artery anomalies are infrequently seen during coronary angiography, and are usually diagnosed incidentally. Among such anomalies, absence of the left circumflex artery is extremely rare. We report on a 49-year-old man who presented with a 2-month history of increasing exertional breathlessness and was found to have poor left ventricular function on echocardiography. Routine coronary angiography showed a normal left anterior descending, no left circumflex artery and a dominant right coronary artery. Neither aortography nor pulmonary angiography showed a separate ostium for the left circumflex artery. Multidetector computed tomographic coronary angiography was performed to confirm the diagnosis of congenital absence of the left circumflex artery.