Single coronary artery with myocardial bridging is rare but associated with the risk of sudden cardiac death in children, yet there is no standardized treatment approach. We report a 6-year-old girl with chest pain having a single coronary artery with complete myocardial bridging of the left main coronary artery (modified Lipton type RII-S) branching from the right coronary artery at an acute angle. Coronary angioplasty using an in situ aortic flap and an autologous pulmonary arterial patch combined with myocardial unroofing was successfully performed for the left main coronary artery. The patient remains healthy for over 3 years without any exercise restriction.
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