Patient with STEMI due to an occlusion of the middle segment of the right coronary artery. As another finding, conventional angiography showed common ostium of both coronary arteries at the right coronary sinus and a "malignant" course had been suspected.

The prospective ECG-triggered CTA of the coronaries shows the common origin out of the right coronary sinus and a transseptal course of the LCA between the aortic root and the pulmonary outflow tract.

Coronary bypass surgery is planned.