Secondary coronary artery ostial lesions: Three case reports

Figure 1 Electrocardiography and imaging manifestations of Case 1. A: Electrocardiography showed atrial fibrillation, complete right bundle branch block and depressed ST segment of 0.1–0.3 mV in leads V1-V6; B: Chest X-ray was normal; C: Coronary angiography showed severe stenosis in the left main coronary ostium; D: Chest computed tomography (CT) showed thymic carcinoma involving the middle mediastinum; E: Chest CT showed thymic carcinoma involving the middle mediastinum, which also invaded the left main coronary ostium. LM: Left main.

Figure 2 Coronary angiography and aortic computed tomography manifestations of Case 2. A: Coronary angiography (CAG) showed right coronary artery (RCA) ostium occlusion and RCA sinus aneurysm; B: After the operation, CAG showed that the distal blood flow of the RCA recovered from thrombolysis in myocardial infarction grade 2; C: Aortic computed tomography (CT) showed an aneurysm arising from the right coronary sinus, which caused severe stenosis of the RCA ostium; D: Aortic three-dimensional CT reconstruction showed an aneurysm arising from right coronary sinus, which caused severe stenosis of the RCA ostium. RCA: Right coronary artery.

Figure 3 Coronary computed tomography angiogram manifestations of case 3. A: Coronary computed tomography angiogram (CTA) maximal intensity projection showed right coronary artery (RCA) ostia severe stenosis; B: Coronary CTA curved planar reconstruction showed abnormal origin of the RCA originating from the left sinus of Valsalva and coursing between the aorta and pulmonary trunk that caused severe stenosis of the RCA ostium. RCA: Right coronary artery.