A rare case of coronary artery bypass grafting in pediatric cardiac surgery: emphasizing the importance of internal thoracic artery usage.

Coronary artery bypass grafting (CABG) is an exceedingly rare procedure in pediatric cardiac surgery, primarily due to the low incidence of coronary artery disease in this population. However, when indicated, the use of the internal thoracic artery (ITA) as a graft is crucial for ensuring long-term success. This case report describes a patient with a coronary artery anomaly where the right coronary artery is taking its origin from the left main coronary artery and transversing along the right ventricle outflow tract. The patient experienced late coronary compression after Rastelli operation, highlighting the critical role of ITA grafts in the surgical treatment.