Search

Bland–White–Garland (BWG) syndrome is a rare congenital heart disease in which the left coronary artery originates from the pulmonary artery (PA). Surgical treatment to rebuild a dual coronary system is recommended at the time of the diagnosis. However, no effective operative procedure has been established for adult-type BWG patients because of the paucity of such cases. We herein report a case of adult-type BWG that was successfully treated by patch closure of the orifice of the left main tract from the main PA and coronary artery bypass grafting. 123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 201thallium (Tl) dual myocardial single-photon emission computed tomography (SPECT) were performed before surgery, early after surgery, and at three months after surgery. Before surgery, dual SPECT showed myocardial perfusion defects in the anterior and septal wall, which corresponded to the cardiovascular magnetic resonance imaging findings. Early after surgery, only 201Tl images demonstrated an improvement in the defect area. At three months after surgery, both the 201Tl and 123I-BMIPP imaging findings demonstrated an improvement in the defect area, which was correlated with the recovery of the left ventricular function. These results showed the effectiveness of this surgical approach for BWG syndrome. < Learning objective: Adult-type Bland–White–Garland syndrome is a rare congenital disease and no effective operative procedure has been established because of the paucity of such cases. The patient in this report underwent patch closure of the orifice of the left main tract from the main pulmonary artery and coronary artery bypass grafting. Myocardial dual single-photon emission computed tomography was considered to be effective for evaluating the results of revascularization surgery, and an improved uptake on 123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid images was closely related to an improvement in the left ventricular function.> [ABSTRACT FROM AUTHOR]

Bland-White-Garland syndrome (BWG) is a congenital heart disease characterized by anomalous origin of left coronary artery from main pulmonary artery. The anomaly causes significant myocardial ischemia, mitral insufficiency, and high infant mortality. Several investigators have reported that the subjects who survived to adulthood showed extensive collateral flow from right coronary artery (RCA). We report a case of newly diagnosed BWG in an elderly patient who had well-developed collaterals from aneurysmal giant RCA and bronchial artery, which were identified by coronary angiography with multi-detector computed tomography. < Learning objective: Structural heart disease is occasionally hard to assess with invasive angiography. In this case, multi-detector computed tomography demonstrated complicated structure of anomalous coronary morphology including collateral sources from extra-cardiac anastomoses. The severity of anomaly related myocardial ischemia was evaluated by image fusion with radionuclide myocardial perfusion. Multimodal imaging approach can provide comprehensive and incremental information.> [ABSTRACT FROM AUTHOR]

Background Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), also known as Bland–White–Garland syndrome, is a rare congenital condition which can manifest as various cardiac symptoms. Case report A 66-year-old woman who presented for pre-operative surgical risk assessment for hip surgery underwent a nuclear stress test which revealed a large reversible anterior defect. At coronary angiography she was found to have ALCAPA. Conclusions This is a rare case of ALCAPA due to the patient's age. Survival to adulthood is possible and patients may remain relatively asymptomatic for years. < Learning objective: Discuss the common clinical manifestations of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Discuss the imaging findings of ALCAPA. Discuss the treatment options for ALCAPA.> [ABSTRACT FROM AUTHOR]

Anomalous origin of the right coronary artery (ARCA) from the main pulmonary artery is a rare congenital anomaly, unlike the well-known anomalous origin of the left coronary artery (Bland-White-Garland syndrome) from the pulmonary artery. Since most ARCA cases are diagnosed during childhood, few adult cases have been reported. We describe the case of a patient who demonstrated ventricular arrhythmia and low cardiac function due to ischemic heart disease and an ARCA. Coronary angiography revealed flow from the left coronary artery to the pulmonary artery via an epicardial collateral artery and the right coronary artery. Multidetector-row computed tomography provided a definitive diagnosis of ARCA; the patient underwent surgical revascularization. [ABSTRACT FROM AUTHOR]

We experienced two adult cases of anomalous origin of the left coronary artery from the pulmonary artery, so-called Bland–White–Garland (BWG) syndrome, that presented with ventricular tachycardia (VT) and ventricular fibrillation during exertion in daily life. They presented to our hospital with syncope due to VT, and recovered following application of an automated external defibrillator with cardiopulmonary resuscitation. We diagnosed BWG syndrome by multi-detector computed tomography angiography and coronary angiography. We analyzed the mechanisms of lethal arrhythmias in relation to myocardial ischemia on exertion. Coronary flow modification and implantable cardioverter defibrillator implantation were performed in order to prevent future lethal arrhythmia due to myocardial ischemia. It is important to be aware of congenital heart disease in ordinary cases. < Learning objective: We experienced two rare cases of patients who were admitted with ventricular tachycardia and ventricular fibrillation who had adult type Bland–White–Garland syndrome during exertion in daily life. It is important to be aware of congenital heart disease in ordinary cases.> [ABSTRACT FROM AUTHOR]

Abstract: Anomalous origin of the left coronary artery from the pulmonary artery is rare but causes myocardial ischemia and sudden death. A few patients with this anomaly can survive to adulthood without sufficient collateral coronary flow or surgical intervention. We present here a case of acute inferior myocardial infarction, which may occur due to thrombotic occlusion of the right coronary artery, in a 63-year-old woman with anomalous origin of the left coronary artery from the pulmonary artery, providing specific coronary angiographic findings. [Copyright &y& Elsevier]

Bland-White-Garland (BWG) syndrome is a rare congenital heart disease in which the left coronary artery originates from the pulmonary artery (PA). Surgical treatment to rebuild a dual coronary system is recommended at the time of the diagnosis. However, no effective operative procedure has been established for adult-type BWG patients because of the paucity of such cases. We herein report a case of adult-type BWG that was successfully treated by patch closure of the orifice of the left main tract from the main PA and coronary artery bypass grafting. 123 I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 201 thallium (Tl) dual myocardial single-photon emission computed tomography (SPECT) were performed before surgery, early after surgery, and at three months after surgery. Before surgery, dual SPECT showed myocardial perfusion defects in the anterior and septal wall, which corresponded to the cardiovascular magnetic resonance imaging findings. Early after surgery, only 201 Tl images demonstrated an improvement in the defect area. At three months after surgery, both the 201 Tl and 123 I-BMIPP imaging findings demonstrated an improvement in the defect area, which was correlated with the recovery of the left ventricular function. These results showed the effectiveness of this surgical approach for BWG syndrome. < Learning objective: Adult-type Bland-White-Garland syndrome is a rare congenital disease and no effective operative procedure has been established because of the paucity of such cases. The patient in this report underwent patch closure of the orifice of the left main tract from the main pulmonary artery and coronary artery bypass grafting. Myocardial dual single-photon emission computed tomography was considered to be effective for evaluating the results of revascularization surgery, and an improved uptake on 123 I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid images was closely related to an improvement in the left ventricular function.>., (© 2019 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare congenital condition which can manifest as various cardiac symptoms., Case Report: A 66-year-old woman who presented for pre-operative surgical risk assessment for hip surgery underwent a nuclear stress test which revealed a large reversible anterior defect. At coronary angiography she was found to have ALCAPA., Conclusions: This is a rare case of ALCAPA due to the patient's age. Survival to adulthood is possible and patients may remain relatively asymptomatic for years.< Learning objective: Discuss the common clinical manifestations of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Discuss the imaging findings of ALCAPA. Discuss the treatment options for ALCAPA.>.