Pediatric Cardiology

, Volume 40, Issue 1, pp 221–225 | Cite as

Transcatheter Intervention for Treatment of Coronary Stenosis After Unroofing of the Anomalous Left Coronary Artery

  • Abhishek Chakraborty
  • Cesar Mendoza
  • Juan Infante
  • Satinder K. SandhuEmail author
Case Report


Anomalous origin of left coronary artery (LCA) from the right coronary cusp with an intramural course is usually managed with unroofing of the intramural segment. Available literature demonstrates an uneventful course following surgery in most patients. Coronary stenosis following the unroofing procedure treated with percutaneous coronary intervention has not been described in the past. We describe a case where an 11-year-old girl with anomalous origin of the LCA from the right coronary cusp presented with near syncope. Surgical unroofing of the intramural segment was done without any post-operative complications and the patient remained asymptomatic for 9 months. She then presented with chest pain, abnormal troponin levels, and ST-T wave changes on EKG. A CT angiogram done revealed short segment narrowing of the LCA near its origin. Cardiac catheterization with coronary angiography demonstrated short segment narrowing of the LCA just distal to origin. Stenting of the left main coronary artery was done with a drug eluting stent. She underwent the procedure without complications. The patient continued to be asymptomatic 16 months after placement of the stent and there was no residual stenosis seen on a repeat CT angiogram at 3 months after the procedure.


Coronary vessel anomalies Coronary angiography Drug eluting stent Congenital heart disease pediatric 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and was approved by the Institutional Review Board, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Abhishek Chakraborty
    • 1
  • Cesar Mendoza
    • 2
  • Juan Infante
    • 3
  • Satinder K. Sandhu
    • 1
    Email author
  1. 1.Department of Pediatrics, Division of CardiologyUniversity of Miami, Miller School of Medicine, Holtz Children’s Hospital/Jackson Memorial HospitalMiamiUSA
  2. 2.Department of CardiologyJackson Memorial HospitalMiamiUSA
  3. 3.Department of RadiologyUniversity of Miami, Miller School of MedicineMiamiUSA

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