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Pediatric Radiology

, Volume 37, Issue 9, pp 890–895 | Cite as

Bland-White-Garland syndrome of anomalous left coronary artery arising from the pulmonary artery (ALCAPA): a historical review

  • Robert A. Cowles
  • Walter E. Berdon
Historical Perspective

Abstract

The landmark 1933 case report from Massachusetts General Hospital by Bland, White and Garland (Am Heart J 8:787–801) described a 3-month-old child with progressive feeding problems, cardiomegaly on chest radiography, and EKG evidence of left ventricular damage. Of interest was the fact that the vigilant father of the infant was Aubrey Hampton, a radiologist and future chairman of radiology at Massachusetts General Hospital. At autopsy, the left coronary artery originated from the pulmonary artery rather than from the aorta. Effective treatment for this condition was not available until 1960 when Sabiston, Neill and Taussig showed that the blood flowed from the left coronary artery toward the pulmonary artery. The anomalous left coronary artery was ligated at its junction with the pulmonary artery and the child survived. This historical review of Bland-White-Garland syndrome, now known as anomalous left coronary artery arising from the pulmonary artery (ALCAPA), stresses the continued diagnostic significance of cardiomegaly on chest radiography and EKG changes suggesting left ventricular damage in 2- to 3-month-old infants with feeding intolerance or irritability. With a high index of suspicion, an echocardiogram can be obtained to confirm the diagnosis. Modern surgical methods involve left coronary artery translocation and afford excellent outcomes.

Keywords

Anomalous coronary artery Edward Franklin Bland Paul Dudley White Joseph Garland Children 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Division of Pediatric Surgery,Columbia University College of Physicians and SurgeonsThe Morgan Stanley Children’s Hospital of New York-PresbyterianNew YorkUSA
  2. 2.Department of Pediatric Radiology, Columbia University College of Physicians and SurgeonsThe Morgan Stanley Children’s Hospital of New York-PresbyterianNew YorkUSA

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