An anomalous origin of the left anterior descending coronary artery from the pulmonary trunk with the right and left circumflex arteries arising from the aorta is very rare and the diagnosis made only at necropsy. An anomalous coronary artery was suspected owing to unexplained cardiomegaly in a 17 month old girl and the anatomy was defined by angiography. The anomalous vessel was successfully reimplanted into the aorta.
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