We present a patient with the extremely rare coexistence of two distinct coronary artery malformations: anomalous aortic origin of the right coronary artery from the left aortic sinus with intramural course and anomalous origin of the circumflex coronary artery from the right pulmonary artery. Surgical reimplantation of the anomalous left circumflex coronary artery to the aorta and unroofing of the intramural portion of the anomalous right coronary artery were performed.
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