Hostname: page-component-77c89778f8-7drxs Total loading time: 0 Render date: 2024-07-19T13:10:28.285Z Has data issue: false hasContentIssue false

Left main coronary artery atresia in a child: a case report and review of the literature

Published online by Cambridge University Press:  03 August 2017

Tomohiro Hayashi*
Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
Kenji Waki
Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
Yoshio Arakaki
Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Japan
Correspondence to: T. Hayashi, Department of Pediatrics, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan. Tel: +8 186 422 0210; Fax: +8 186 421 3424; E-mail:


Congenital atresia of the left coronary artery is a very rare condition. We report a case of a 13-year-old boy who was followed-up at our outpatient clinic from 6 months of age because of heart murmur. He had no symptoms for more than 10 years, and his left ventricular contraction was normal. Exercise electrocardiogram was performed at 7 and 10 years of age, and ST depression was not observed. He presented with chest pain and syncope on exertion at the ages of 11 and 12 years, respectively, and ST depression on exercise electrocardiogram was detected for the first time at 13 years of age. Cardiac echocardiography showed a high-choic antero-lateral papillary muscle of the mitral valve, prolapse of the mitral anterior leaflet, and mild mitral valve regurgitation. Coronary angiography did not demonstrate antegrade left coronary flow or dilation of the right coronary artery. We performed coronary artery bypass grafting using the left internal thoracic artery. Postoperatively, the ST depression resolved, and his exercise tolerability improved.

Brief Report
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1. Satran, A, Dawn, B, Leesar, M. Congenital ostial left main coronary artery stenosis associated with a bicuspid aortic valve in a young woman. J Invasive Cardiol 2006; 18: E114E116.Google Scholar
2. Koh, E, Nakagawa, M, Hamaoka, K, et al. Congenital atresia of the left coronary ostium: diagnosis and surgical treatment. Pediatr Cardiol 1989; 10: 159162.Google Scholar
3. Fortuin, NJ, Roberts, WC. Congenital atresia of the left main coronary artery. Am J Med 1971; 50: 385.Google Scholar
4. Goormaghtigh, N, De Vos, L, Blanquaert, A. Ostial stenosis of the coronary arteries in a nine years old girl. Arch Intern Med 1955; 95: 341348.Google Scholar
5. Eguchi, T, Nomura, Y, Yotsumoto, G, et al. A case of atresia of the left coronary ostium. Heart 2003; 35: 825882.Google Scholar
6. Hung, JW. Ischemic (functional) mitral regurgitation. Cardiol Clin 2013; 31: 231236.Google Scholar
7. Musiani, A, Cernigliaro, C, Sansa, M, et al. Left main coronary artery atresia: literature review and therapeutical considerations. Eur Cardiothorac Surg 1997; 11: 505514.CrossRefGoogle ScholarPubMed
8. Amaral, F, Tanamati, C, Granzotti, JA, et al. Congenital atresia of the ostium of the left coronary artery. Diagnostic difficulty and successful surgical revascularization in two patients. Arq Bras Cardiol 2000; 74: 339342.Google Scholar
9. D’Souza, TF, Samuel, BP, Vettukattil, JJ, et al. Surgical treatment of neonate with congenital left main coronary artery atresia. Ann Thorac Surg 2016; 101: 352355.CrossRefGoogle ScholarPubMed