A 2-month-old girl presenting with heart failure and murmur was investigated using Doppler echocardiography and cardiac catheterization revealing an anomalous left coronary artery origin from the pulmonary trunk and massive mitral regurgitation. The patient was submitted to surgery under cardiopulmonary bypass: the anomalous coronary artery was implanted in the aorta and the mitral valve repaired by annuloplasty. In the postoperative period the patient had important mechanical hemolysis caused by the mitral annuloplasty. The patient underwent a second intervention to remove a piece of bovine pericardium. A postoperative echocardiogram revealed mild mitral insufficiency and the patient is free of symptoms.
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