A 5-year-old boy underwent ventricular septal defect closure as well as resection of the muscle bundle of a double-chamber right ventricle and a subaortic membrane. Five days after surgery, echocardiography revealed a left anterior descending artery fistula with 2 sites of entry to the right ventricle. The child was asymptomatic with no murmurs. Echocardiography is an excellent tool for detecting such silent clinical lesions.
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