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Anomalous Origin of Left Coronary Artery from the Pulmonary Trunk in a Mildly Symptomatic Adult Female

DOI: 10.1155/2013/840741

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Anomalous origin of the left coronary artery from the pulmonary trunk, also known as Garland-Bland-White syndrome, is an extremely rare but potentially fatal congenital cardiovascular anomaly, and it often exists as an isolated condition. We hereby report an adult female who was admitted for mild chest discomfort and was accidentally diagnosed to have anomalous origin of the left coronary artery from the pulmonary trunk. This anomaly was simply repaired by using a bovine pericardial patch to obliterate the anomalous opening in the pulmonary trunk and a single coronary artery bypass graft. This report highlights the characteristic events of the anomaly in an adult with only mild symptoms. 1. Introduction Anomalous origin of the left coronary artery from the pulmonary trunk, also known as Garland-Bland-White syndrome, is an extremely rare but potentially fatal congenital cardiovascular anomaly, and it often exists as an isolated condition. Some reports have found its association with tetralogy of Fallot (TOF), complete atrioventricular septal defect, and aortopulmonary (AP) window, which arises secondary to failure of septation in the aorticopulmonary trunk [1–10]. 2. Case Report The patient is a 36-year-old female school teacher who was in her normal state of health until two years prior to the present admission when the patient started to feel occasional pressure-like chest discomfort and palpitation. The patient went to a local hospital for help. Mild mitral regurgitation was told, and the patient was then discharged with medical management as an outpatient. However, one month prior to the present admission, the patient’s chest tightness, although still mild on onset, had increased in frequency. The patient went back to the same hospital for further evaluation. This time, a cardiac catheterization was performed and accidentally revealed anomalous drainage of left coronary artery (LCA), including all its branches (like the left anterior descending artery, left circumflex artery, and the left diagonal artery), into the main pulmonary artery. Single right coronary artery (RCA) originated from the aorta, and mild mitral regurgitation was seen concurrently in the cardiac catheterization. Upon recommendations from the patient’s family, the patient came to our hospital and was admitted for surgical managements. After the patient was admitted into our service, chest X-ray, ECG, carotid ultrasound, pulmonary function test, pressure volume recording, blood analysis, and viral check were done and all revealed normal findings. No fever, leukocytosis, or any sign

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