Anomalous origin of right coronary artery from left aortic sinus.

Saphenous vein bypass grafting relieved myocardial ischemia caused by the anomalous origin of the right coronary artery from the left aortic sinus in a premenopausal woman. Contrary to the conventional impression, the anomaly is associated with sudden death, aborted death, angina, vasospasm, arrhythmia and cardiac dysfunction and is diagnosed more frequently on angiography. The literature is reviewed and the guidelines for diagnosis and surgical management of this not-so-rare but potentially serious anomaly are presented.