Abstract
One of the rarest isolated congenital anomalies of the coronary arteries (CA) is left main coronary artery ostial atresia (LMCAOA). Clinical manifestations of this pathology vary from asymptomatic to severe coronarogenic myocardial injury and even sudden death, depending on the state of collateral blood flow, which provides retrograde filling of the left CA from the right CA. Acute coronary insufficiency in children often manifests in syncopal conditions. If a routine cardiological examination does not reveal any pathology, the child may mistakenly become a patient with the neurological department. In this regard, the clinical observation given in the article is instructive: when the stress test made it possible to suspect, then the CT angiography confirmed the left main coronary artery ostial atresia in a 6 years old male patient. Mammary coronary artery bypass grafting, further supplemented by stenting of the resulting narrowing of the anastomosis, has allowed to achieve a good clinical effect with a favorable 2-year follow-up.
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