Abstract
Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly, known as Bland-White-Garland (BWG) syndrome. Most patients with this anomaly require surgical intervention early in life, and it is extremely rare that patients reach middle age without any symptoms. We report the surgical treatment of a BWG syndrome in an adult patient. A 51-year-old man was admitted because of congestive heart failure and atrial fibrillation. Coronary catheterization revealed an anomalous origin of the left coronary artery from the pulmonary trunk and aneurysm of the right coronary artery. The patient was treated with a new technique using an internal tunnel created in the left side main pulmonary artery with a pericardial patch roll. A bypass with an artificial graft was made between this pericardial roll and the ascending aorta. Replacement of the aneurysm of the right coronary artery was also performed. The post operative course was uneventful. The postoperative CT showed the successful results of this operation.
