Abstract
An 18-year-old female suffering from severe mixed rheumatic mitral valve disease was operated on for mitral valve replacement. During the operation, an unusual swelling was noticed near the non-coronary sinus of the aorta, which turned out to be the left circumflex coronary artery. From its origin the artery curved around the right side of the aorta and then traversed in the transverse sinus to follow its normal course. The left anterior descending artery was arising from the left coronary sinus and the right coronary artery was arising from the right coronary sinus. This rare congenital anomaly was not suspected preoperatively as the patient did not have any relevant symptoms. Preoperative transthoracic echocardiography also failed to pick up this anomaly. However, postoperative detailed transthoracic echocardiography provided evidence of an abnormal vessel arising from the non-coronary sinus.
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