Minimally Invasive Direct Coronary Artery Bypass—a Surgical Approach for Anomalous Right Coronary Artery From Left Aortic Sinus of Valsalva

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Anomalous origin of the right coronary artery from the left aortic sinus of Valsalva, although rare, has been associated with myocardial ischemia and sudden death. Methods of surgical correction include ostial reconstruction, excision and translocation of the vessel origin, and coronary artery bypass grafting. We describe a 39-year-old man with symptoms of myocardial ischemia and an anomalous right coronary artery in whom we performed the new, minimally invasive direct coronary artery bypass procedure with use of the right internal mammary artery.