[Bland-White-Garland syndrome. Clinical aspects, diagnosis, therapy].
The anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland Syndrome) is a rare congenital malformation reported to occur in 0.25-0.5% of all congenital cardiac anomalies. The clinical and pathomorphological picture can be classified into 2 types: infantile or adult. The infantile type is thought to lack coronary collaterals; this explains the bad prognosis and symptoms of non-operated patients. In the adult type collaterals are present or have developed in time to provide adequate blood supply to the myocardium. No history of cardiac complains and a nearly normal ECG are common findings. Echocardiography and cardiac catheterisation are mandatory diagnostic tools. The value of new methods like NMR, "stop-flow" angiography and color doppler flow mapping is still in discussion. The reimplantation of the coronary artery and Takeuchi-Operation are well established surgical methods. The time for the operation and prognostic outcome are related to the preoperative underlying myocardial damage measured by left ventricular function.
Pfannschmidt
J
J
Klinik und Poliklinik für Herzchirurgie, Universität zu Köln.
Ruskowski
H
H
de Vivie
E R
ER
D002675:Child, Preschool; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D011651:Pulmonary Artery / Q000002:abnormalities*; D013536:Suture Techniques
Das Bland-White-Garland-Syndrom (BWGS). Klinik, Diagnostik, Therapie.