Norwood procedure for hypoplastic left heart with anomalous coronary artery from pulmonary trunk

Undetected coronary anomalies at Norwood procedure are associated with poor prognosis due to inadequate myocardial protection. We report a case of anomalous origin of the right coronary artery from the main pulmonary artery trunk with hypoplastic left heart syndrome and aortic atresia. Although, during bilateral pulmonary artery banding as initial palliation, the proximity between the right coronary artery origin and the aortic root made a visual diagnosis difficult, it was diagnosed using computed tomography before the Norwood procedure. The Norwood procedure is safe in patients with coronary anomalies following accurate diagnosis to ensure intraoperative myocardial protection.