Coronary artery anomalies are often discovered incidentally during cardiac catheterization or computed tomography coronary angiography and may involve the affected coronary artery origin and its course. Coronary artery anomalies are associated with congenital heart disease. The affected coronary arteries may have an unusual high take off origin, origin from contralateral or non-coronary sinus, origin from the pulmonary artery, single coronary system or coronary artery fistula.
Bland White Garland Syndrome

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) has rarely been reported on in adults because 90% of the untreated infants die in the first year of life. We report here on a case of ALCAPA that was detected in a 41-year-old woman and she was successfully treated by direct re-implantation of the anomalous coronary artery into the aorta.
Adult* ; Aorta ; Bland White Garland Syndrome ; Coronary Vessel Anomalies ; Coronary Vessels* ; Female ; Humans ; Infant ; Mitral Valve Insufficiency ; Pulmonary Artery*

Anomalous origin of left coronary artery from pulmonary artery(ALCAPA) is a rare fatal congenital anormaly that needs early surgical intervention. Many reports say that the choice of operative procedure is reimplantation of the left coronary artery into the ascending aorta. We experienced the surgical management of a case of the ALCAPA. The patient was 44 days old and 3.45 kg weighed female baby who had a symptom of congestive heart failure. She underwent implantation of coronary artery on the aorta with cardiopulmonary bypass and recovered without any complications.
Aorta ; Bland White Garland Syndrome ; Cardiopulmonary Bypass ; Coronary Vessels* ; Female ; Heart Failure ; Humans ; Pulmonary Artery* ; Replantation ; Surgical Procedures, Operative

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is a rare congenital cardiovascular anomaly. The mortality rate among infants and children without operation has been eighty to ninety-five percents and few patients survive till teen-age or adulthood. This anomaly was detected during elective coronary angiogram in a 32 year-old female patient with atypical chest pain. Reversible ischemia was demonstrated on myocardial 201Tl-SPECT. Coronary angiogram revealed anomalous origin of left coronary artery from pulmonary artery.
Adult* ; Bland White Garland Syndrome ; Chest Pain ; Child ; Coronary Vessels* ; Female ; Humans ; Infant ; Ischemia ; Mortality ; Pulmonary Artery

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare coronary artery anomaly and double right coronary artery (RCA) is a very rare coronary anomaly. Because patients with ALCAPA usually die within 1 year of being born due to myocardial infarction (MI) and heart failure, ALPACA is very rarely seen in adults. Here, we report an extremely rare asymptomatic case of MI, presumably caused by ALCAPA and double RCA, and provide a review of the literature. This is the first reported case of coronary artery anomaly that had both ALCAPA and double RCA.
Adult ; Bland White Garland Syndrome ; Camelids, New World ; Coronary Vessel Anomalies ; Coronary Vessels ; Heart Failure ; Humans ; Myocardial Infarction ; Pulmonary Artery

The congenital anomalous origin of the left coronary artery arising from the pulmonary artery, or the Bland-White-Garland syndrome, is uncommon but frequently lethal lesion of both children and adults. In several series, it has a frequency of 0.26-0.46% of all congenital cardiac defects. The mortality rate among infants and children without operation has been eighty to ninety percent. Survival to teen-age and adult has been infrequent ; review of the literature regarding this anomaly in Korean disclosed only 3 cases in infants and children and 2 cases in adults. In a 45-year-old male with palpitation and effort angina, the anomalous origin of the left coronary artery from the pulmonary artery was diagnosed by echocardiogram and coronary arteriography.
Adult ; Angiography ; Bland White Garland Syndrome ; Child ; Coronary Vessels ; Humans ; Infant ; Male ; Middle Aged ; Mortality ; Pulmonary Artery

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), also termed Bland-White-Garland syndrome, is a rare congenital cardiac anomaly characterized by myocardial ischemia which becomes symptomatic during early infancy leading to infarction, left heart failure or even death. More than 90% of patients can be dead within first year of life if untreated, so adult type ALCAPA without surgical correction is quitely rare. We present a case of a 20-year-old man with ALPACA syndrome whose diagnosis took several years to be made because he was mistaken to have organic mitral regurgitation.
Adult* ; Bland White Garland Syndrome ; Camelids, New World ; Coronary Vessels* ; Diagnosis ; Heart Failure ; Humans ; Infarction ; Mitral Valve Insufficiency ; Myocardial Ischemia ; Pulmonary Artery* ; Young Adult

We report a case of an 8 years and 11 month-old male patient who had developed severe tricuspid insufficiency(TI) after correction of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA). Transthoracic echocardiogram and coronary angiography confirmed ALCAPA, ischemic mitral regurgitation and trivial TI. He underwent direct reimplantation of the left coronary artery to the aortic root by using additional cannulation at the main pulmonary artery for arterial inflow and cardioplegia delivery to the left coronary artery. After the correction of ALCAPA, transesophageal echocardiogram(TEE) revealed good antegrade flow at the aortic implantation site of the left coronary artery and severe TI(Gr III-IV/IV). Cardiopulmonary bypass was reestablished and tricuspid valve was repaired with Kay-type annuloplasty, artificial chordae formation and chordal shortening plasty. The postrepair TEE revealed trivial to mild TI.
Bland White Garland Syndrome ; Cardiopulmonary Bypass ; Catheterization ; Coronary Angiography ; Coronary Vessels* ; Heart Arrest, Induced ; Humans ; Infant ; Male ; Mitral Valve Insufficiency ; Pulmonary Artery ; Replantation ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Anomalous origin of the left coronary artery from pulmonary artery was first described in a child by Brooks. This ALCAPA syndrome is a rare congenital anomaly occuring in approximately 0.25~0.50% of children having congenital heart disease. Although approximately 80 to 90% of patients develop congestive heart failure and die in infancy, some pateints may present this syndrome in adolescents or adults. This anomaly was detected during elective coronary angiogram in a 63 year-old female patient with typical angina. Down-sloping ST depression was demonstrated on exercise stress ECG. Coronary angiogram and pulmonary angiogram revealed an anomalous origin of left coronary artery from pulmonary artery.
Adolescent ; Adult* ; Bland White Garland Syndrome ; Child ; Congenital Abnormalities ; Coronary Angiography ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography ; Female ; Heart Defects, Congenital ; Heart Failure ; Humans ; Middle Aged ; Pulmonary Artery*