Origin of an anomalous left coronary artery from a left hilar pulmonary artery

Anomalous coronaries arising in nontruncal regions of the pulmonary artery are exceedingly rare. We report an autopsy case of an anomalous left coronary artery that arose from the distal pulmonary artery at the hilum of the left lung in an infant with complex congenital heart disease. To the best of our knowledge, this is the first such report. This previously unknown coronary malformation led to a fatal intraoperative complication during a pulmonary angioplasty procedure.