CTICasesEndothelial Hood covering Left Main Coronary Ostium
Imaging findings
Non-gated CT angiography in a 7-year-old child resuscitated from sudden cardiac arrest shows normal coronary origins, but surgical exploration revealed a redundant endothelial tissue flap (endothelial hood) intermittently covering the left main coronary artery ostium.
Key takeaways
Intermittent coronary ostial obstruction by an accessory endothelial tissue hood is an extremely rare congenital anomaly and a cause of sudden cardiac arrest in pediatric patients. Because the anatomy looks normal on standard imaging, surgical exploration is required if catheter engagement is difficult and markers are elevated.
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