Anomalous origin of circumflex coronary artery from right pulmonary artery: report of a rare anomaly.

A heretofore unreported anomaly of the coronary arteries in which a large circumflex artery arises from the pulmonary artery is described. The circumflex coronary artery in an 8-year-old girl was filled in a retrograde fashion via collaterals from a dominant left anterior descending coronary artery, and the right coronary artery was small and nondominant. Successful surgical correction of this defect was performed by use of total cardiopulmonary bypass and cardioplegic arrest. The orifice of the anomalous vessel and detached from the right pulmonary artery and implanted into the posterolateral aspect of the ascending aorta. Cardiopulmonary bypass with cardioplegic arrest is recommended for reconstruction of coronary arterial anomalies with abnormal sites of origin.