Figure 2

RCA arising from left sinus of Valsalva with a separate ostium (Subgroup 4a). Image A (Volume Rendering Technique) depicts the whole coronary artery tree. RCA and LM are originating from the left sinus of Valsalva (LSV) with separate ostia (as shown in Image B, curved Multiplane Reformatting). Again note the ovoid cross-sectional image of the proximal intramural RCA course (left cross-sectional picture of Image A). Additionally, this patient obviously underwent stent implantation procedure (stent in mid LAD with good contrast enhancement within the stent lumen) due to CHD. Furthermore note the bright calcified plaque proximal to the previously implanted stent. This severe calcification causes so-called "blurring" impairing the luminal view. A high grade stenosis therefore cannot be ruled out. Interestingly, proximal LAD and RCA do not show any additional atherosclerotic plaque formation as depicted in the remaining cross-sectional images. Furthermore small calcified deposits (spotty calcification) are found at the aortic valve leaflets. LCX: left circumflex ramus; DB: diagonal branch; LAD: left anterior descending coronary artery; LM: left main coronary artery; LSV: left sinus of Valsalva; PA: pulmonary artery; RCA: right coronary artery.