Tripodi A et al. - Coronary anomalies can involve origin or distribution of the artery. Most of these anomalies are not clinically important. A single coronary artery arising from the right coronary sinus of Valsalva is an extremely rare anatomic anomaly. Usually coronary artery malformation is associated with other cardiac malformations and the diagnosis is made after birth. More rarely, coronary artery anomalies are an isolated and asymptomatic cardiac malformation.