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\begin{document}

\title{ANOMALOUS AORTIC ORIGIN OF THE LEFT MAIN CORONARY ARTERY ASSOCIATED WITH
ARTERIAL COMPRESSION - CASE REPORT}



\author[1]{Davi Tenório}%
\author[1]{Leonardo Miana}%
\author[2]{Antonio Carlos de Almeida Barbosa Filho}%
\author[3]{Monica Gonzales Coronel}%
\author[1]{Gustavo Guerreiro}%
\author[4]{Valdano Manuel}%
\author[1]{Marcelo Jatene}%
\author[5]{fabio Jatene}%
\affil[1]{Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo}%
\affil[2]{Centro Universitário CESMAC}%
\affil[3]{Universidade de São Paulo Instituto do Coração}%
\affil[4]{Clínica Girassol}%
\affil[5]{Instituto do Coração, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo}%


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  \date{May 15, 2024}


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\begin{abstract}
Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding,
with varied presentation and symptomatology. Increasingly recognized by
cardiac imaging, when found it raises questions about the appropriate
approach and management. We present a case of an 11-year-old female who
presented with episodes of shortness of breath, angina and syncope
during exercise. Further investigation demonstrated episodes of
nonsustained ventricular tachycardia on Holter and coronary
angiotomography revealed that the left coronary artery had an anomalous
origin from the right cusp with initial short intramural segment and
significant external compression in its initial course between the aorta
and the pulmonary artery. Patient was submitted to surgical correction
with dissection of left coronary artery posterior to the pulmonary
artery, coronary arteriotomy, roof ampliation with autologous
pericardium and creation of neo-ostium in aorta. Patient had
satisfactory postoperative recovery, was discharged on the fifth day
post op, and remains asymptomatic after six months follow-up. Herein we
present surgical video and postoperative echo and CT scan.%
\end{abstract}%



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