Coronary ostial stenosis in an infant with nonischemic anomalous left coronary artery from the pulmonary artery

Imaging details of asymptomatic, nonischemic cases of anomalous left coronary artery from the pulmonary artery (ALCAPA) diagnosed in infancy are not well established. A 6-month-old girl was diagnosed with ALCAPA but showed normal left ventricular contraction. Echocardiography and coronary angiography revealed abundant collateral pathways from the right coronary artery to the left coronary artery (LCA), with the opening of the pulmonary artery narrowed to 1.5 mm and a restricted continuous flow from the LCA to the pulmonary artery. Coronary ostial stenosis could be one of the findings in asymptomatic, nonischemic ALCAPA.