Younus Zilfah, Iftikhar Rawail, Ahmed Iftikhar
Intensive Care (ITC) / Anaesthesiology2, Armed Forces Institute of Cardiology and National Institute of Heart Disease, Rawalpindi.
J Coll Physicians Surg Pak. 2013 Oct;23(10):743-4. doi: 10.2013/JCPSP.743744.
Anomalous origin of the left coronary artery from the pulmonary artery also recognized as Bland White Garland syndrome is a very rare congenital condition. A two-months old baby boy presented with dyspnoea for two weeks and a pansystolic murmur on auscultation. The base line investigations showed cardiomegaly and bilateral basal haze on X-ray chest. ECG showed ST elevation in leads l and AVl and echocardiography showed situs solitus, levocardia, hypokinetic intraventricular septum, ejection fraction of 30%, mitral regurgitation of grade-I and an anomalous origin of the left coronary artery from pulmonary artery was diagnosed. Patient was in left heart failure. It was rectified surgically by creating a transpulmonary tunnel (Takeuchi repair). Postoperative course was uneventful and he was finally discharged in stable condition.
左冠状动脉起源于肺动脉（也被称为布兰德-怀特-加兰综合征）是一种非常罕见的先天性疾病。一名两个月大的男婴出现了两周的呼吸困难，听诊时有全收缩期杂音。基线检查显示X线胸片上有心脏扩大和双侧肺底部模糊影。心电图显示I导联和AVl导联ST段抬高，超声心动图显示心房正位、心脏左位、室间隔运动减弱、射血分数为30%、一级二尖瓣反流，诊断为左冠状动脉起源于肺动脉异常。患者处于左心衰竭状态。通过建立一个经肺动脉隧道（竹内修复术）进行了手术矫正。术后过程平稳，他最终在病情稳定的情况下出院。
