SUCCESSFUL OPERATION IN AN OLD SURVIVOR OF ANOMALOUS ORIGIN OF THE LEFT CORONARY-ARTERY FROM THE PULMONARY TRUNK (BLAND-WHITE-GARLAND SYNDROME)

A case of anomalous origin of the left coronary artery from the pulmon ary trunk is reported. The patient, a 64-year-old woman, presented wit h a history of angina and cardiac failure. She was known to have had a mitral systolic murmur since school age. Echocardiography showed clin ically significant mitral regurgitation and highly unusual extensive c alcification of the mitral valve chordae, papillary muscle, and poster ior left ventricular wall-a pattern suggesting the possibility of abno rmal coronary circulation. Subsequent cardiac catheterisation confirme d considerable mitral regurgitation with a dilated left ventricle, and arteriography confirmed anomalous origin of the left coronary artery from the main pulmonary trunk. The patient was surgically treated with ligation of the origin of the anomalous left coronary and mitral valv e replacement. She was alive and well 2 years after operation.