[Anomalous origin of the left coronary artery from the pulmonary artery. Treatment by left subclavian-left main coronary artery anastomosis].

The technique of left subclavian-main left coronary artery is described as the treatment of anomalous origin of the left coronary artery from the pulmonary artery, without the aid of cardiopulmonary bypass, which, however, remains on standby. Through a left postero-lateral thoracotomy, the left main coronary artery is detached from the main pulmonary artery with a cuff of pulmonary wall after lateral clamping of the pulmonary artery. Tapes are encercling the pulmonary artery and the descending thoracic aorta, making them ready for an eventual connection to the standby bypass, in case the coronary clamping is not well tolerated. The anastomosis between the left subclavian artery dissected free and the prepared left main coronary artery is then possible and easy even in a small infant. This technique has been used in three infants aged three to thirty months without any mortality nor particular morbidity.