We present a case of a 14-year-old boy with a recurrent syncope during exercise, diagnosed with a rare coronary anomaly: an intramural single coronary trunk between the great arteries. The trunk originated from the left sinus of Valsalva with acute angle take-off and ran intramurally. He underwent successful surgical repair using the unroofing technique. Postoperative recovery was uneventful, and he remains symptom-free 3 years after surgery. This report shows a novel application of the unroofing technique for this unique anomaly.
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