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An 84-year-old female presented with exertional angina. Coronary angiography demonstrated an anomalous coronary artery with a single ostium arising from the right coronary sinus with a calcified stenosis of the ‘common right main-stem’ (CRMS), and only mild plaque disease distally in the left coronary artery (LCA) (figure 1A). CT coronary angiography confirmed the anatomy (figure 1B), and the heart team discussion recommended intervention.
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