Abstract: Objective To analyze the clinical data of 10 children with coronary artery anomalies originating from the opposite coronary sinus (AAOCA) in order to improve the early diagnosis of the disease. Methods The clinical symptoms,transthoracic echocardiography (TTE) and CT coronary angiography (CTCA) results of 10 children with AAOCA in our hospital from June 2018 to June 2019 were summarized and analyzed. Results Eight children were diagnosed as AORCA and 2 cases were diagnosed as anomalous origin of left coronary artery from the right sinus（AOLCA）by TTE in 10 children with AAOCA . There were no typical chest pain and syncope after exercise for children. The resting electrocardiogram was normal. The results of CTCA showed that the abnormal origin of coronary artery was located between the aorta and pulmonary artery. There were 7 cases with opening stenosis (AORCA 5 cases, AOLCA 2 cases), 4 cases with compression stenosis of the main artery (all AORCA), 1 case with AOLCA and intramural segment, 8 cases with acute angle (AORCA 6 cases, AOLCA 2 cases), and 1 case with AORCA and high opening. Conclusion TTE can be used to diagnose AAOCA in children without typical clinical symptoms and normal ECG. In addition to definite diagnosis, CTCA is more important to find abnormal origin of the coronary artery between the aorta and pulmonary artery, stenosis of the orifice, sharp starting angle and the combination of intramural segments and other risk factors, so as to avoid strenuous exercise and timely surgical treatment.

Key words: coronary vessel anomalies, child, echocardiography, tomography, X-ray computed