Abstract
We herein report the case of a 37-year-old woman in whom an anomalous origin of the left coronary artery from the pulmonary artery was surgically corrected. A magnetic resonance angiogram showed the left main coronary artery connecting to the right posterior portion of the pulmonary trunk, and exercise-stressed thallium-201 perfusion scintigrams demonstrated a large reversible anterior defect. She was successfully treated by direct aortic reimplantation of the abnormal left coronary artery. We were able to obtain a sufficient length of the left main trunk by excising the large cuff of pulmonary artery wall surrounding the ostium of the anomalous left coronary artery while transecting the pulmonary artery. Postoperative angiograms demonstrated a widely patent left coronary artery, a decrease in the size of the right coronary artery, and no collaterals, and exercise-stressed thallium-201 perfusion scintigrams demonstrated no remaining ischemic defect at all. Direct aortic reimplantation is an ideal operation but is still limited by the anatomical position of the left coronary artery. In this case, magnetic resonance angiography was an excellent method for deciding the optimum operative procedure for the anomalous left coronary artery. In addition, exercise thallium-201 scintigraphy was found to be useful in recognizing the revascularized effect of the left ventricle.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bunton R, Jonas RA, Lang P, Rein AJJ, Castaneda AR (1987) Anomalous origin of left coronary artery from pulmonary artery. J Thorac Cardiovasc Surg 93:103–108
Backer CL, Stout MJ, Zales VR, Muster AJ, Weigel TJ, Idriss FS, Mavroudis C (1992) Anomalous origin of left coronary artery: A twenty-year review of surgical management. J Thorac Cardiovasc Surg 103:1049–1058
Neches WH, Mathews RA, Park SC, Lenox CC, Zuberbuhler JR, Siewers RD, Bahnson HT (1974) Anomalous origin of the left coronary artery from the pulmonary artery: A new method of surgical repair. Circulation 50:582–587
Grace RR, Angelini P, Cooley DA (1977) Aortic implantation of anomalous left coronary artery arising from pulmonary artery. Am J Cardiol 39:608–613
Laks H, Ardehali A, Grant PW, Allada V (1995) Aortic implantation of anomalous left coronary artery. J Thorac Cardiovasc Surg 109:519–523
Smith A, Arnold R, Anderson RH, Wilkinson JL, Qureshi SA, Gerlis LM, McKay R (1989) Anomalous origin of the left coronary artery from the pulmonary trunk. J Thorac Cardiovasc Surg 98:16–24
Takeuchi S, Imamura H, Katsumoto K, Hayashi I, Katohgi T, Yozu R, Ohkura M, Inoue T (1979) New surgical method for repair of anomalous left coronary artery from pulmonary artery. J Thorac Cardiovasc Surg 78:7–11
Tashiro T, Todo K, Haruta Y, Yasunaga H, Nagata M, Nakamura M (1993) Anomalous origin of the left coronary artery from the pulmonary artery: New operative technique. J Thorac Cardiovasc Surg 106:718–722
Cooley DA, Hallman GL, Bloodwell RD (1966) Definitive surgical treatment of anomalous origin of left coronary artery from pulmonary artery: Indications and results. J Thorac Cardiovasc Surg 52:798–808
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Saito, T., Fuse, K., Kato, M. et al. Anomalous left main coronary artery arising from the pulmonary artery in an adult: Treatment by direct reimplantation. Surg Today 26, 453–456 (1996). https://doi.org/10.1007/BF00311937
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00311937