Septal Course of the Left Main Coronary Artery Originating From the Right Sinus of Valsalva

A 53-year-old man with ischemic dilated cardiomyopathy underwent successful orthotopic heart transplantation. The postoperative course was uneventful. Routine control angiography shortly after transplantation revealed an anomalous origin of the left main coronary artery (LMCA) from the right sinus of Valsalva (Figure 1). An intraseptal course between the aorta and the right pulmonary outflow tract with retrograde filling of the left anterior descending artery was demonstrated by simultaneous coronary angiography …