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Ann Thorac Surg 2003;76:267-269
© 2003 The Society of Thoracic Surgeons

Case report

A reoperation of Adult-Type Bland-White-Garland syndrome

Tetsuya Niino, MDa*, Motomi Shiono, MDa, Tatsuya Inoue, MDa, Mitsumasa Hata, MDa, Akira Sezai, MDa, Nanao Negishi, MDa

a Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan

Accepted for publication January 17, 2003.

* Address reprint requests to Dr Niino, Second Department of Surgery, Nihon University School of Medicine, 30-1 Ooyaguchi, Kamimachi, Itabashi-ku, Tokyo 173-0081, Japan
e-mail: xj8t-nin{at}asahi-net.or.jp

We present a 25-year-old female patient with Bland-White-Garland syndrome (anomalous origin of the left coronary artery from the pulmonary artery) who underwent mitral valve replacement (MVR) and coronary artery bypass grafting. She had previously undergone MVR and had been treated by the Takeuchi procedure for mitral valve regurgitation and a coronary artery anomaly, respectively, at 17 years of age. She was hospitalized with shortness of breath within 7 years of surgical intervention. Swan-Ganz catheterization revealed mild pulmonary hypertension and elevated mean pulmonary wedge pressure. Echocardiography revealed marked severe calcification of the bio valve and moderate mitral valve regurgitation. Coronary angiography revealed retrograde collateral blood flow from the right coronary artery to the left coronary artery, but intrapulmonary tunnel was not visualized by pulmonary arteriography. We performed MVR with a mechanical valve and coronary artery bypass grafting between the left internal thoracic artery and the left anterior descending artery. The postoperative course was unremarkable, and no complaints were reported during follow-up at the outpatient clinic.




This article has been cited by other articles:


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 Ann. Thorac. Surg.Home page
C. K. Choong, C. Martinez, H. B. Barner, and P. A. Ludbrook
Bland-White-Garland Syndrome in Pregnancy: Reoperation of ALCAPA With an Internal Thoracic Radial Artery "Y"-Graft
Ann. Thorac. Surg., April 1, 2006; 81(4): 1512 - 1514.
[Abstract] [Full Text] [PDF]


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