THROMBOTIC OBSTRUCTION OF THE RIGHT CORONARY-ARTERY IN A POSTOPERATIVE-PATIENT WITH BLAND-WHITE-GARLAND SYNDROME

A 53-year-old female presented with symptoms of severe chest and back pain associated with oliguria. The patient had a history of exertional dyspnea since the age of 20, and easy fatigability since the age of 2 7. At the age of 41, she noted marked exacerbation of these symptoms a fter suffering from a cold and was ultimately diagnosed as having Blan d-White-Garland (BWG) syndrome with mitral valve regurgitation. The pa tient then underwent re-implantation of an anomalous left coronary art ery from the pulmonary artery to the posterolateral wall of the aorta. Eleven years later, she re-presented with symptoms of angina and cong estive heart failure. Coronary angiography was subsequently performed and a total occlusion of the right coronary artery with probable throm bus was revealed. The right coronary artery was filled via collaterals from the implanted left coronary artery. Mitral regurgitation was not ed during angiography. The patient underwent aorto-coronary artery byp ass grafting of the right coronary artery and concomitant mitral valve replacement. Her post-operative condition remained excellent.