Suhair Shebani, Riyanka Gupta, Saravan Durariraj, Branko Mimic
We report the case of a previously healthy 10-year-old girl who experienced sudden cardiac arrest during a cross-country event. Prompt bystander cardiopulmonary resuscitation was initiated and continued until ambulance arrival. The initial rhythm was polymorphic ventricular tachycardia, which converted to sinus rhythm after cardioversion. Cardiac computed tomography (CT) confirmed anomalous origin of the left main coronary artery from the non-facing sinus, with a slit-like ostium and acute take-off. Coronary artery ostioplasty using a CardioCel patch was performed. Postoperative recovery was excellent; mid-term surveillance with CT, magnetic resonance imaging, Holter monitoring, and stress echocardiography demonstrated a patent left main coronary artery, no evidence of ischemia, and normal cardiac function. This case highlights rapid resuscitation, early recognition, individualized surgical management, and mid-term follow-up in rare coronary artery anomalies. To our knowledge, this is the first reported use of a CardioCel patch in coronary ostioplasty for anomalous aortic origin of the coronary artery.