AN ADULT CASE OF BLAND-WHITE-GARLAND SYNDROME WITH COLLATERALS FROM THE BRONCHIAL ARTERY

We report herein an adult case of anomalous origin of the left coronar y artery from the pulmonary artery (Bland-White-Garland syndrome; BWG syndrome). The patient had chest discomfort during exercise and signs of mitral regurgitation. We diagnosed him as having BWG syndrome by an giography, and performed surgical treatment. At the operation, retrogr ade coronary blood flow was found through the left coronary artery dur ing aortic cross-clamping. This suggested extracardiac anastomosis fro m peripheral arteries to the left coronary artery. Since the collatera l blood flow was considerable during aortic cross-clamping, only the l eft coronary artery was closed. A collateral from the left bronchial a rtery to the left circumflex artery was demonstrated by postoperative angiography. Cases of adults with BWG syndrome are rare, and this may be the first report of a collateral from the bronchial artery.