Figure 2:
A: Two-dimensional transoesophageal echocardiography in
mid-oesophageal short-axis view of the aortic valve reveals the
anomalous origin of the left coronary artery from the opposite sinus
with an inter-arterial course. The right and left coronary arteries
shared the same coronary ostium. The anomalous coronary artery had an
acute take-off angle (defined as < 45°) with an origin below
the commissure. B: Color flow Doppler demonstrates flow through
the left anomalous coronary artery. C-D: We used
three-dimensional transoesophageal echocardiography to allow the
observer to look directly at the ostium of the coronary artery. First,
mid-oesophageal aortic valve short axis view was obtained rotating the
transducer angle to 30°. Slight anteflexion of the probe was required.
Once a wide-angled acquisition of the three-dimensional data set of the
aortic root was obtained, the cropping plane was aligned parallel to the
coronary artery ostium. The origin of the right coronary artery can be
seen (yellow arrow) inside the shared coronary ostium (yellow
arrowhead). LM = Left main coronary artery. RCS = Right coronary sinus
of Valsalva.