Definitive surgical treatment of anomalous origin of left coronary artery. A new technical approach used successfully in a seven-month-old male infant.

Anomalous origin of left coronary artery from the pulmonary artery is a very rare cardiac anomaly. Most patients with this defect die in the first year of life. Reconstructive surgery of the left coronary artery is the only saving measure in the management of this disease. A radical operation was successfully carried out in a seven-month-old boy by interposing a homologous saphenous vein (from his mother) between the aorta and left coronary artery. The operation was performed by use of deep hypothermia with surface cooling combined with limited cardiopulmonary bypass. The postoperative clinical course was uneventful and the patient relatively asymptomatic. Postoperative coronary angiograms revealed that the interposed homologous vein graft was patent, although it was slightly stenotic. Following the operation the patient showed good development and growth and has now reached 2 years of age. The purpose of this paper is to present the case by discussing our new operative technique.