Benign or malignant anomaly? Very high takeoff of the left main coronary artery above the left coronary sinus.

Very high takeoff of the left main coronary artery in the absence of another coronary anomaly is a rare finding. The pathologic consequences of this anomaly are unclear, and the literature on this subject does not agree on whether the condition is dangerous. We present our findings in 2 patients who were discovered to have this anomaly upon noninvasive computed tomographic coronary angiography, and we discuss our analysis of the literature and our management of these patients.