Anomalous origin of left coronary artery with aortopulmonary window - a case report with surgical correction and delayed control.

A 9-month-old male baby was investigated for a massive left-to-right shunt at the arterial level. On right heart catheterization a patent ductus could not be demonstrated but retrograde arterial angiography showed an aorto-pulmonary window. During corrective surgery on cardiac bypass, the left coronary artery was found to arise from the aorto-pulmonary window, this was corrected by dividing the communication distal to the origin of the left coronary artery. On follow-up investigation 6 months after operation the baby was without symptoms and showed a fully functional left coronary artery. To our knowledge this is the first case of such a congenital anomaly to be described.