Independent origin of the entire coronary system along with the right conus artery within the right sinus of Valsalva associated with intramyocardial tunneling

Coronary artery variations are considered to be important as they may lead to or predispose the patients to develop myocardial ischemia or sudden cardiac death. We report an anatomic variation with independent origin of the entire coronary system along with the right conus artery within the right sinus of valsalva and intramyocardial tunneling of the anterior descending branch of the right coronary artery which is very rare. The present case contributes to better understanding of the coronary artery variations as this type of combined anatomical variation of the coronary arteries has not been described in the literature before.