Zilfah Younus, Rawail Iftikhar, Iftikhar Ahmed.
Anomalous origin of left coronary artery from pulmonary artery (ALCAPA).
J Coll Physicians Surg Pak Jan ;23(10):743-4.

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 inraventricular 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 transpulmonary tunnel (Takeuchi repair). Postoperative course was uneventful and he was finally discharged in stable condition.

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