The coronary arteries are tortuous and dilated. The right coronary artery arises from the anterior coronary sinus of the aortic root. The left main coronary artery arises from the main pulmonary artery. The left anterior descending and circumflex coronary arteries arise from the left main coronary artery. Multiple collaterals are seen. There is reflux of contrast from the left main coronary artery into the main pulmonary artery suggestive of reversal of flow. No significant stenosis or coronary fistula identified in this examination.
Overall findings are consistent with anomalous left coronary artery from the pulmonary artery (ALCAPA).