Coronary artery anomalies are known to be associated with truncus arteriosus (common arterial trunk). Delineation of coronary anatomy preoperatively is important to avoid complications intraoperatively and postoperatively. We report the case of a 12-year-old boy with repaired truncus arteriosus who presented with moderate to severe truncal valve regurgitation and severe conduit stenosis. He was noted to have intramural left main coronary artery on a transesophageal echocardiogram performed preoperatively.
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