Aortic Origin Coronary Artery Anomalies: A Case Series

Coronary artery anomalies (CAAs) are rare, but they can cause serious consequences, complicate the diagnosis of coronary artery disease (CAD), and hamper the ability of the physician to perform the correct intervention for patients with CAD. The widespread use of coronary computed tomography and angiography has shown that the incidence is higher than previously thought. CAAs can occur with various anatomical features. We present three rare examples. The first example involves a circumflex artery (CX) that originates from a different ostium on the right side, despite the presence of left arteries in normal anatomical structures. The second case involves an accessory CX originating from the right coronary artery (RCA) ostium, despite the CX origin being in the left cusp. Finally, the third case involves an accessory left anterior descending artery (LAD) originating from the RCA ostium, despite the LAD origin being in the left cusp. There were no high-risk features in all three cases, and no symptoms were observed during follow-up with the patients. The occurrence of these cases is exceptional and may be overlooked; hence, their identification has significance.