Figure 32.6. Anomalous origin of the left main coronary artery from the pulmonary artery. A: In the fetus,both right and left coronary arteries receive forward flow from the great arteries. B: Early after birth, beforecollaterals are well developed, there may be an anterolateral infarct and slight retrograde flow from the leftcoronary artery to the pulmonary artery. C: After collaterals have enlarged, there is high flow in the enlargedright coronary artery and the collaterals and significant retrograde flow into the pulmonary artery. Arrowsindicate direction and approximate magnitude of flow in the right and left coronary arteries and thecollaterals between them. A, aorta; LAD, left anterior descending coronary artery; LCX, left circumflexcoronary artery; P, pulmonary artery; RCA, right coronary artery.
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