Origin of the right from the left main coronary artery (single coronary ostium in aorta)

Origin of both the right and left main (LM) coronary arteries from the aortic wall of the right sinus of Valsalva frequently is a lethal anomaly.¹ Origin of both the right and LM coronary arteries from the aortic wall of the left sinus of Valsalva, in contrast, usually is a benign anomaly.² Although many studies have described origin of both LM and right coronary arteries from the aortic wall of the same sinus of Valsalva, few^1,2 have described origin of the right coronary artery from the LM. Husaini et al³ described angiographic features of this anomaly in a 52-year-old man who underwent selective coronary angiography after probable acute myocardial infarction. Muus and McManus⁴ described this anomaly in a fullterm stillborn infant who also had a bicuspid aortic valve. Whether the coronary anomaly played a role in the stillbirth is uncertain. In both of these previously described patients, the anomalously arising right coronary artery coursed between aorta posteriorly and the pulmonary trunk anteriorly.