Giant Calcified Left Circumflex Coronary Artery Aneurysm With Complex Coronary-to–Left Ventricular Communication

A 64-year-old asymptomatic man had an incidental finding of a giant left circumflex artery (LCX) aneurysm, with the distal LCX draining into a confluence receiving terminal portions of all coronary arteries and communicating with the left ventricle through a transmural fistulous tract. We believe that this is the first case reported with such a complex LCX abnormality. (Level of Difficulty: Beginner.)