Anomalous origin of left coronary artery from pulmonary artery [ALCAPA]

ABSTRACT

Anomalous origin of the left coronary artery from the pulmonary artery also recognized as Bland White Garland syndrome is a very rare congenital condition. A two-months old baby boy presented with dyspnoea for two weeks and a pansystolic murmur on auscultation. The base line investigations showed cardiomegaly and bilateral basal haze on X-ray chest. ECG showed ST elevation in leads I and AVI and echocardiography showed situs solitus, levocardia, hypokinetic intra-ventricular septum, ejection fraction of 30%, mitral regurgitation of grade-I and an anomalous origin of the left coronary artery from pulmonary artery was diagnosed. Patient was in left heart failure. It was rectified surgically by creating a trans-pulmonary tunnel [Takeuchi repair]. Postoperative course was uneventful and he was finally discharged in stable condition