Single coronary artery trunk originating from tubular aorta-Can it be a risk factor for coronary artery disease?

The high take-off of the coronary artery is rarely encountered in the catheterization laboratory. But the origin of a single coronary artery with high take-off makes it even more rare. The high take-off of a single coronary artery may have an association with coronary artery disease, as in this case. In the present case, a 55-year-old male underwent a coronary angiogram, but coronaries could not be cannulated despite multiple catheter usage. Then, computed tomography was performed which revealed high take-off of single coronary artery and had triple vessel disease, for which coronary artery bypass surgery was performed successfully. <Learning objective: Difficulty or inability of cannulation of coronary arteries on angiography should have a suspicion of anomalous origin of coronary arteries. Computed tomography is the investigation of choice for identifying the anomalous origin of the coronary artery and its course, as conventional coronary angiogram may not depict an abnormal course of the coronary artery, which may be clinically significant.>.