Anomalous origin of right coronary artery from left coronary sinus has been considered a minor disease without relevance. Currently it is associated with all symptoms derived from myocardial ischemia because of its lower coronary reserve. We present one patient with anomalous origin of right coronary artery from left coronary sinus surgically treated with saphenous vein aorto-coronary bypass. Doppler velocimetry shows the improvement of myocardial reserve after surgery.