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+).
Keywords: ALXCAPA; anomalous origin of the left circumflex coronary artery from the pulmonary artery; coronary CT angiography; coronary vessels anomalies.