The last three cases are examples of those which encouraged my attitude that anything can happen and to stick to your guns if the images are good. In this case, our interpretation of the CT was challenged by the angiographers, but surgery showed us to be right. 56 year old man with chronic aortic valve disease. Previous single coronary vein graft to the left lateral coronary system. Recent mechanical aortic valve and root replacement, with button re-implantation of the coronary arteries into the Gore-Tex of the root replacement tube. A few weeks later, acute, persistent chest pain. Have a look at the CT below, answer on the next page.