Journal of Pediatric Cardiology and Cardiac Surgery

Anomalous origin of the left coronary artery from the pulmonary artery rarely coexists with other cardiac malformations. Herein, we report an infant with this combination of abnormalities. A clear sign of myocardial ischemia detected by electrocardiography led to a correct diagnosis soon after birth. The infant underwent staged repair; direct reimplantation of the left coronary artery to the ascending aorta at first, followed by intracardiac repair of the tetralogy of Fallot subsequently. After the initial repair of anomalous origin of the left coronary artery from the pulmonary artery, the patient had her cardiac function improved. During follow-up of 4 years at the outpatient clinic, the patient has been in a good condition. A staged repair approach was a viable surgical option for this rare combination of malformations.