Surgical angioplasty for ostial atresia of left main coronary artery in child.

Ostial atresia of the left main coronary artery (LMCA) in children without any primary disease is extremely rare. We present here a case of occlusion of the LMCA in a 9-year-old girl. Myocardial scintigraphy showed poor perfusion in both domains of the left anterior descending artery (LAD) and left circumflex artery (LCx). Coronary artery graphy (CAG) showed complete ostial atresia of the LMCA and retrograde perfusion from the thin collateral arteries into the LAD. We performed angioplasty using an autologous pericardium onlay patch. Her postoperative course was unremarkable. Postoperative CAG showed vanishing collateral arteries, confirming anterograde flow through the LAD and LCx, and myocardial scintigraphy showed improvement in perfusion.