The authors report a case of coronary arterial anastomosis between the right coronary and left circumflex arteries in the absence of other coronary pathology. This is an exceptionally rare congenital malformation which is situated either in the atrioventricular groove or at the apex in the interventricular groove. It constitutes a diagnostic pitfall because, in contrast to a collateral circulation, it is not an indirect sign of occlusive coronary artery.

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