A Rare Case of Neonatal Cardiac Ischemia due to Intermittent Aortic Insufficiency.

We report a case of a 23-day-old girl who presented with repeated life-threatening myocardial ischemia from intermittent aortic insufficiency due to fixation of the left coronary cusp against the aortic wall. The patient underwent aortic valve repair with partial commissuroplasty of the left-right and left-non commissures. Following the surgical intervention, the patient has been well, with no ischemic event for over 1 year. This diagnosis should be considered as a differential diagnosis in pediatric cases with myocardial ischemia. Although myocardial ischemia in early infancy is rare, it is potentially life threatening. Early diagnosis is pivotal to prevent irreversible cardiac dysfunction and/or death. The causes of myocardial ischemia include coronary arterial lesions, coronary ostial lesions, and embolisms (1, 2). Diagnosing the cause of myocardial ischemia is integral to the planning of a precise treatment strategy. Here, we report an extremely rare case of a 23-day-old girl with life-threatening myocardial ischemia due to intermittent aortic insufficiency (AI).