Anomalous Origin of the Left Main Coronary Artery from the Right Sinus of Valsalva

We present a case, previously not reported, of anomalous origin of the left main trunk from the right aortic sinus with anterior course, in which anomalous left main trunk bifurcated and traversed anterior to the pulmonary artery. Moreover, ostial spasm was combined and resulted in hemodynamic instability in the presence of infarcted right coronary artery.