LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

Abstract

Three cases of left coronary artery arising from the pulmonary artery in infants are reported, making a total of 35 cases now reported. One of these was apparently complicated by cardiac rupture, a sequence, to the authors' knowledge, not previously reported. The symptom complex is again reviewed in order to stimulate interest in earlier diagnosis. Since eight cases of this anomaly have been reported in adults, one of whom lived to 64 years, it is suggested that the life of the infant might be saved if diagnosed before irreversible myocardial changes have occurred. The ideal treatment, if vasodilatory drugs fail, would seem to be a direct anastomosis of the left coronary with the aorta; however, since technically this is impossible at the present time, other methods of increasing the flow to the left coronary should be attempted. Gasul suggests the Pott's-Smith operation, which, by raising the pulmonary pressure, might increase the left coronary flow.