case_images: PMC9922200_01
case_images: EKG strip demonstrating a Brugada type I pattern
case_images: cureus-0015-00000033718-i01.jpg
case_images: PMC9922200_01_cureus-0015-00000033718-i01.jpg
case_images: FIG1
case_images: An electrocardiogram showed precordial ST changes consistent with a Brugada type I pattern (Figure 1).
case_images: CTA coronary showing the anomalous origin of the RCA (arrow) arising from the left coronary cusp. RCC: right coronary cusp; LCC: left coronary cusp; RCA: right coronary artery
case_images: cureus-0015-00000033718-i02.jpg
case_images: PMC9922200_01_cureus-0015-00000033718-i02.jpg
case_images: FIG2
case_images: CAD, including mid-left anterior descending (LAD) artery chronic total occlusion (CTO) with the right to left collaterals, left circumflex, and RCA with the accompanied anomalous origin of RCA. Computed tomography angiography (CTA) coronary without calcium score (Figure 2) was ordered, which showed an anomalous origin of RCA from the left coronary cusp that has a malignant course between the aorta and pulmonary artery.
case_images: RCA after exiting the malignant course between the aorta and pulmonary artery. RCA: right coronary artery
case_images: cureus-0015-00000033718-i03.jpg
case_images: PMC9922200_01_cureus-0015-00000033718-i03.jpg
case_images: FIG3
case_images: Ligation of the proximal RCA was also performed to prevent competitive flow under a resting state (see intraoperative pictures in Figures 3-5).
case_images: Close-up of vein anastomosis to the RCA. RCA: right coronary artery
case_images: cureus-0015-00000033718-i04.jpg
case_images: PMC9922200_01_cureus-0015-00000033718-i04.jpg
case_images: FIG4
case_images: Ligation of the proximal RCA was also performed to prevent competitive flow under a resting state (see intraoperative pictures in Figures 3-5).
case_images: Close-up of pledgets ligating the proximal end of the RCA. RCA: right coronary artery
case_images: cureus-0015-00000033718-i05.jpg
case_images: PMC9922200_01_cureus-0015-00000033718-i05.jpg
case_images: FIG5
case_images: Ligation of the proximal RCA was also performed to prevent competitive flow under a resting state (see intraoperative pictures in Figures 3-5).