Sorodoc L, Păduraru D, Sorodoc A N, Păduraru L
Facultatea de Medicină Clinica Urgenţe Medicale, Spitalul de Urgenţe, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2001 Jul-Sep;105(3):457-61.
The anormalous origin of the left coronary artery from pulmonary artery (White-Bland Garland syndrome) is a very rare coronary malformation, having despite the great mortality in the early childhood, an adult form, characterized by minor symptoms and long course. This paradoxical situation is totally dependant to the complete development of the coronary anastomosis, allowing the right coronary flow to perfuse the left myocardium. The theory of the "terminal arterial perfusion" of the heart, still persistent in some monographs is meeting in this natural situation its strongest opponent argumentation. The coronary anastomosis, clearly visible by coronarography are large enough (in late stages) to inverse the flow in left coronary artery, filling the pulmonary artery. Is the coronary-pulmonary shunt, responsible for the majority of symptoms, in the 5th or 6th decade. The adult form of the White-Bland Garland syndrome is indicative for the maximum result we may hope to reach using the new revascularisation method for ischemic heart disease: new vessels formation and enhancing the coronary anastomosis by growth factors administration therapy.
左冠状动脉起源于肺动脉（怀特-布兰德-加兰综合征）是一种非常罕见的冠状动脉畸形，尽管在儿童早期死亡率很高，但存在一种成人形式，其特征为症状轻微且病程较长。这种矛盾的情况完全取决于冠状动脉吻合支的完全发育，使右冠状动脉血流能够灌注左心肌。心脏“终末动脉灌注”理论在一些专著中仍然存在，而在这种自然情况下，它遇到了最有力的反对论据。冠状动脉造影清晰可见的冠状动脉吻合支（在晚期）足够大，能够使左冠状动脉内的血流反向，充盈肺动脉。冠状动脉-肺动脉分流是导致大多数症状的原因，出现在五六十岁时。怀特-布兰德-加兰综合征的成人形式表明了我们使用缺血性心脏病新血管重建方法可能希望达到的最大效果：通过给予生长因子疗法形成新血管并增强冠状动脉吻合支。
