Intramural anomalous left coronary artery from the right sinus of Valsalva supported with venoarterial extracorporeal membrane oxygenation.

We report the case of a 14-month-old girl with a wide complex dysrhythmia and cardiogenic shock due to abnormal coronary anatomy. She was kept alive for 20 days by full cardiocirculatory support, using venoarterial extracorporeal membrane oxygenation (VA ECMO). While she was on VA ECMO, a diagnosis was made of extensive myocardial infarction and an anomalous left main coronary artery. The patient was listed for heart transplantation and received a donor heart 20 days after beginning VA ECMO. We discuss the unusual presentation and course of the coronary arteries and the use of VA ECMO to support this patient before heart transplantation.