A rare coronary anomaly: the single left coronary artery with coronary artery fistula draining into the right ventricular outflow tract

A previously healthy 9-year-old girl was referred to us for the evaluation of a murmur on routine clinical examination. Routine electrocardiogram and chest X-ray were normal. The cardiac enzymes were normal. Combining ultrasound and CCTA, it was confirmed that the hemodynamics of the heart was a left-to-right shunt and that RVOT stole blood from the left ventricle through the single coronary artery (SCA).