The normal anatomy for the coronary arteries involves their origin from the aorta at each of two separate sites. Sometimes people can be born with the origin of a coronary artery that comes from an abnormal site and this can lead to problems of coronary ischemia which can subsequently lead to a heart attack. Not all coronary anomalies need surgery, but some do and the specific operation depends on which of the many varieties of coronary anomalies is present.