My cherry has been popped. Read about it, looked at imaging but never have found one in the wild.

Mar 25, 2026 · 3:29 PM UTC

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A follow up. He is scheduled for Left Main reimplantation in 2 weeks. Preoperatively, a coronary CTA was ordered as the surgeon wants to know if the distance to the reimplantation site. CCTA shows an anomalous circumflex, retro aortic!
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It shouldn't be an issue. I can imagine as the patient aged if he developed pulmonary hypertension the flow could reverse. If he had a pulmonary embolus that could be disastrous as well.
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Replying to @aspergian1
Nice case, it’s probably the robust collaterals that allowed it to be undiagnosed until his 60s
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Absolutely
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Replying to @aspergian1 @JASRendon
Never seen one in my life, that's wild!
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Never thought I would.
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Replying to @aspergian1
Oh come on everyone! Tell us ENT folks how we're going to manage this if we ever find it!
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Re-implant Left Main Coronary artery into Aorta
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more replies
Replying to @aspergian1
I was lucky to have two cases of Bland Garland White in my life though one exactly like this - 64yo, routine cath due to risk factors and nonspecific symptoms. Lo and behold. exactly same config with gargantuan RCA.
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Replying to @aspergian1
That is so cool. Thank you for sharing!
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Replying to @aspergian1
Textbook ALCAPA
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Replying to @aspergian1 @HeartOTXHeartMD
Cool case. (do we use the “cherry”expression?)
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Replying to @aspergian1

ALT Game Time Pokemon GIF
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Replying to @aspergian1
ALCAPA
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Replying to @aspergian1
BWG syndrome. Popular question for FIT jeopardy
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Replying to @aspergian1
ALCAPA
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Replying to @aspergian1
Wow!
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Replying to @aspergian1
Insane!!
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Replying to @aspergian1
😬
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Replying to @aspergian1
What is that 🤧
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Replying to @aspergian1
What next ? are you going to plug the exit..
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Replying to @aspergian1
Great case, beautiful angio.
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Replying to @aspergian1
Nice case We described a 60yo active bricklayer with ALCAPA and light SOB, Dx on routine CAG after +ve nuke
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Replying to @aspergian1
🌭 ?
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Replying to @aspergian1 @HeartOTXHeartMD
ALCAPA?
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