Concurrent Presentation of an Anomalous Right Coronary Artery and an Unusual Bovine Arch: Case Report

Anomalous coronary arteries from the opposite sinus of Valsalva are rare but can increase the risk for life-threatening complications. We present the case of a 59-year-old man who was found to have an anomalous right coronary artery and a rare bovine arch variant with a single common brachiocephalic trunk, along with severe proximal left anterior descending artery stenosis on left heart catheterization. The patient underwent a minimally invasive coronary artery bypass graft and unroofing of the anomalous coronary artery. To our knowledge, this is the first reported case of these concurrent anomalies in an individual without tetralogy of Fallot.