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The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 16-24, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
A Smith, R Arnold, RH Anderson, JL Wilkinson, SA Qureshi, LM Gerlis and R McKay
Anomalous origin of the left coronary artery from the pulmonary trunk,
though a discrete anatomic malformation, manifests a spectrum of clinical
and pathologic consequences. The objectives of this study were to
characterize the primary anatomic findings in a group of specimens with
anomalous left coronary artery and the extent of secondary morphologic and
pathologic changes. Although the cases studied probably represent the least
favorable end of the spectrum, the observed pathogenesis and evolution of
secondary changes suggest that reconstruction of a two-coronary arterial
system supplied through two coronary arteries would be advantageous to most
patients. A high origin of the right coronary artery or location of the
left coronary artery adjacent to a pulmonary cusp or branch may complicate
the tunnel-type repair. In these cases, transfer of the left coronary
artery to the aorta may be preferable.
ARTICLES
Anomalous origin of the left coronary artery from the pulmonary trunk. Anatomic findings in relation to pathophysiology and surgical repair
Institute of Child Health, University of Liverpool, Royal Liverpool Children's Hospital Alder Hey, England.
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