A 1-week-old girl died suddenly and unexpectedly. At autopsy the major finding was of a right dominant coronary artery circulation with an inapparent left coronary artery ostium. After careful examination, an anomalous origin of the left coronary artery was found with the ostium located in the non-coronary cusp immediately adjacent to the commissure of the non- and left coronary cusps. The ostium was of small caliber with an obliquely oriented artery (<45°) with no ostial ridges. The artery coursed anteriorly past the left coronary cusp between the aorta and the left atrial appendage to then follow its usual course inferiorly along the anterior aspect of the left ventricle. The reminder of the autopsy was unremarkable. Death was, therefore, attributed to an anomalous and hypoplastic left coronary artery (and ostium) with an acute angle of take-off. Tracing coronary arteries in the very young may be technically difficult due to their small size, thus identifying the location of ostia is important. This may be difficult when the ostium was located close to a commissure.

中文翻译：

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隐藏的冠状动脉口与猝死

一名一周大的女婴突然意外死亡。尸检时的主要发现是右冠状动脉循环占主导地位，左冠状动脉口不明显。仔细检查后，发现左冠状动脉起源异常，开口位于非冠状动脉尖部，紧邻非冠状动脉尖部与左冠状动脉尖部的连合处。开口口径小，动脉倾斜（<45°），没有开口脊。动脉向前经过主动脉和左心耳之间的左冠状动脉尖部，然后沿着左心室的前部向下遵循其通常的路线。尸检的提醒并无异常。因此，死亡归因于具有锐角起飞的异常和发育不全的左冠状动脉（和开口）。由于冠状动脉较小，追踪幼儿的冠状动脉在技术上可能很困难，因此确定冠状动脉口的位置很重要。当口位于靠近连合处时，这可能很困难。