A 9-month-old boy was diagnosed by echocardiography with anomalous origin of the left coronary artery from the pulmonary artery. The left ventricular ejection fraction was 22%. After coronary artery transplantation, low cardiac output developed, and a left ventricular artificial assist (LVAD) was urgently installed. Perioperative cardioprotection is particularly important for children with low cardiac function. With the recent development of extracorporeal circulation technology, LVAD has been increasingly used in children with severe postoperative low cardiac output and significantly reduces the early postoperative mortality in such children.