**3.7 Anomalous connection with the pulmonary artery (type VII)**

In patients with anomalous connection with the pulmonary artery, the most commonly artery is the LMCA. Usually, the latter is connected with the left posterior pulmonary sinus, facing the left posterior aortic sinus. Numerous epicardial collateral vessels are observed between the anomalous coronary artery that arises from the pulmonary artery and the normal contralateral coronary artery that arises from the aorta (fig 7). An origin of the RCA from the pulmonary artery is less frequently than the LCA.

Fig. 7. Aortic angiography view showing an anomalous connection of the left main (white star) with the pulmonary trunk (black arrow) with an enlarged right coronary artery (white arrow) filling by a retrograde flow the left coronary circulation.
