Pediatric Cardiology and Cardiac Surgery
Vol.26 No.3 2010 (251-255)

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Shigehiro Morishima,1) Takashi Ono,1) Makoto Nakazawa,2) Masatomo Honda,3) and Yoshimichi Kudo4)

Departments of 1)Pediatric Cardiovascular Surgery, 2)Pediatric and Life Long Congenital Cardiology Institute, 3)Cardiovascular Center, and 4)Pediatrics, Southern Tohoku General Hospital and Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan


We described a case with high take-off of the left coronary artery associated with a ventricular septal defect that could not be identified by echocardiography. A 4-month-old boy was admitted to our hospital with a heart murmur and poor weight gain. Echocardiography revealed a ventricular septal defect and pulmonary hypertension. Cardiac catheterization showed that pulmonary to systemic flow ratio was 4.2. Aortography demonstrated high take-off of the left coronary artery. After cardiac catheterization, re-echocardiography was performed. The left coronary artery proceeding along the left side of the ascending aorta was revealed. High take-off of the left coronary artery was suspected. The defect was surgically repaired without any coronary events, by placing the aortic clamp high on the ascending aorta.