Khalil zarrabi - Department of cardiovascular surgery,Namazi hospital ,SUMS,Shiraz, IRAN
Abdolali Zolghadr Asli - Department of cardiology,Namazi hospital,SUMS,Shiraz,IRAN
Mohammad Amin Zarrabi - Medical student(intern),SUMS,Shiraz, IRAN

Anatomical variations in origin, course or termination of coronary arteries are increasingly diagnosed (in up to 5% of coronary angiographies) incidentally and however more than 80% of them are benign, rarely may be lethal and malignant & corrective surgery is mandatory to overcome the adverse outcome.Coronary artery take-off from opposite sinus of Valsalva with interarterial course is an anomaly which may disable the patient because of impairment of myocardial blood supply, specially during exercise & may present with ACS.Surgery for such lesions and other rare anomalies are treatment of choice, to preserve myocardial function and is life saving.