Aortic Valve Replacement in Anomalous Aortic Origin of Right Coronary Artery

A 75-year-old man with severe aortic regurgitation was referred to our department for surgery. Coronary angiography revealed 75% stenosis at left coronary artery( LAD) and a normally positioned left coronary artery. However, the location of the right coronary artery was anomalous. The right coronary artery ostium originated from the ascending aorta above the left coronary cusp. Emergency surgery proceeded to address severe dyspnea due to congestive heart failure. The higher portion of the right coronary artery was incised in sigmoid fashion, the aortic valve was replaced with a 23-mm stented bioprosthesis and coronary bypass grafting proceeded. The postoperative course was uneventful