Primary coronary angioplasty in a patient with anomalous origin of the right coronary artery from the left sinus of Valsalva.

We report a rare case of primary coronary angioplasty in a patient with acute myocardial infarction due to thrombotic occlusion of an anomalous right coronary artery arising from the left sinus of Valsalva. The non-invasive method of ischaemia localisation, such as ST-segment elevation on the electrocardiogram, was useful in identifying the infarct-related artery. A major factor was the selection of the guiding catheter to access the anomalous right coronary artery and also to obtain good angiographic visualisation and adequate support for percutaneous coronary intervention.