RESUMO
Coronary connection anomalies are a rare congenital anatomical aberration with an angiographic incidence of around 1%. In the majority of cases, these anomalies are incidentally discovered during coronary angiography or coro CT and remain silent without clinical translation, while in a certain number of cases, they can be responsible for serious clinical manifestations of up to sudden death. Coronary CT is crucial in the management of its patients since it makes it possible to objectify the presence of a pre-aortic course or the existence of an intramural aortic trajectory, two characteristics associated with the occurrence of sudden death. Through four clinical cases we illustrate the different situations in which we had to manage these anomalies.