Abstract
There are a wide range of variations in the course of the coronary arteries. An understanding of the common anomalous courses of the coronaries is helpful when looking at infants and children, in whom the size of the coronary arteries is significantly smaller than those in adults. Anomalies and variations of the course of the coronaries are often seen when their origin is from the opposite sinus. Common pathways for these anomalies of origin are interarterial, prepulmonary, retro- or circum-aortic, trans-septal, and retrocardiac. The interarterial course may be intramural or within the wall of the aorta. This can have adverse clinical outcomes.