CT Detection of an Anomalous Left Circumflex Coronary Artery from Pulmonary Artery (ALXCAPA) in 81-Year-Old Female Patient

Background: The left circumflex coronary artery from the pulmonary artery is a very rare congenital anomaly with few cases described, so far, worldwide. Case report: An 81-year-old female presented complaining of dyspnea. The transthoracic echocardiogram revealed severe degenerative aortic stenosis in addition to a hypertrophied left ventricle with normal function and no wall motion abnormalities. As part of the pre-TAVI planning, she underwent a CT examination, which revealed an anomalous left circumflex artery originating from the right pulmonary artery. The case is currently being managed conservatively. Conclusion: The presented congenital coronary anomaly is, to our knowledge, the first to be described in the literature in this age group (80+).