Anomalous origin of the left anterior descending and circumflex coronary arteries by two separate ostia from the right sinus of Valsalva.

We report a case of absence of the left main coronary artery with the left anterior descending and circumflex coronary arteries arising by two separate ostia from the right sinus of Valsalva in a patient without other congenital cardiovascular malformations. The clinical and angiographic features of this exceedingly rare anomaly are described with a brief review of previously documented cases.