Korean Journal of Pediatrics 2010;53(2):248-252.
Published online February 15, 2010.
Anomalous origin of left coronary artery arising from the right coronary cusp presenting with chest discomfort and syncope on physical exercise
Ran Baik1, Nam Kyun Kim1, Han Ki Park2, Young Hwan Park2, Byung Won Yoo1, Jae Young Cho1
1Division of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
2Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
12세 여아에서 운동 중 발생한 흉통 및 실신 - 왼쪽 주 관상동맥의 이상 기시의 진단 및 수술적 치료 1례
백란1, 김남균1, 박한기2, 박영환2, 유병원1, 최재영1
1연세대학교 의과대학 소아과학교실 소아심장과
2연세대학교 의과대학 흉부외과학교실 심장혈관외과
Correspondence: 
Jae Young Cho, Tel: +82.2-2228-8280, Fax: +82.2-393-3080, Email: cjy0122@yuhs.ac
Abstract
Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA) in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG), and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE) and heart computed tomography (CT). She underwent a corrective operation by re-implantation, CABG, and unroofing.
Key Words: Coronary Vessel Anomalies, Coronary Artery Bypass, Acute Coronary Syndrome, Syncope


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