ANOMALOUS ORIGIN OF ALL CORONARY-ARTERIES FROM THE PULMONARY TRUNK

The origin of both coronary arteries from the pulmonary artery is a ra re cardiac malformation, We report a baby who presented with an echoca rdiographically diagnosed perimembranous ventricular septal defect and normal left ventricular (LV) function, Later on the boy developed fai lure to thrive and increasing tachypnea. At the age of 5 weeks the ECG showed that LV strain and echocardiographic LV function had worsened (FS 18%), Echocardiography and heart catheterization showed that all c oronary arteries originated from the pulmonary trunk. Intraoperative i nspection revealed a single ostium for the right and left coronary art ery in the nonfacing sinus of the pulmonary trunk. A tube was construc ted connecting the coronary artery to the ascending aorta. Coronary pe rfusion was sufficient and the sinus rhythm was restored. However, in the early postoperative period there was a sudden deterioration of car diac output followed by cardiac arrest. Reanimation was not successful .