Late intervention in an asymptomatic pediatric patient with
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Introduction :
This case report describes a late diagnosis of anomalous left coronary artery from the pulmonary artery (ALCAPA) in an asymptomatic patient with only mild left ventricular dilatation. Because of a lack of literature to guide management in our patient, the benefits of surgical revascularization were weighed against risks of surgery on a hemodynamically stable patient with relatively preserved ventricular function. Ultimately, the patient underwent surgery in hopes of preventing further suboptimal coronary perfusion.

Case :
The patient was initially seen with an asymptomatic 2/6 apical systolic murmur at age two. The electrocardiogram was normal and the initial transthoracic echocardiogram demonstrated good ventricular function, no atrial or ventricular septal defect, and mild mitral regurgitation (MR). There was abnormal flow in the region of the left coronary artery (LCA) suspicious for a LCA fistula.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163717/
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