Challenges Faced During Surgical Management of the Anomalous Right Coronary Artery Arising from the Left Coronary Cusp in Adults

Purpose: The anomalous right coronary artery (ARCA) arising from the left coronary cusp is an uncommon congenital anomaly with varied clinical outcome, including sudden cardiac death. Surgical intervention in such patients is performed to prevent this fatal complication. A thorough knowledge of the proximal structures, including the take-off portion, is important in formulating the best surgical treatment option. Recent experiences of a single surgeon (MM) dealing with the ARCA highlight the challenges surgeons can face when dealing with this anomaly intraoperatively.