title: Bland-White-Garland syndrome with ventricular septal defect: late presentation.
abstract: Bland-White-Garland syndrome has been reported generally to occur in an isolated lesion. Here, we report a case of Bland-White-Garland syndrome associated with a ventricular septal defect. Late onset of myocardial ischemia was noted in this patient, which we think is related to increased coronary steal due to regression of pulmonary hypertension caused by narrowing of the ventricular septal defect. At surgery, we temporally occluded the left main coronary trunk to cease the coronary steal phenomenon and augment the left coronary flow. Direct implantation of the left coronary artery and closure of the ventricular septal defect were performed. The postoperative course was excellent with no evidence of myocardial ischemia.
authors.affiliation: Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Minami-ku, Yokohama, Japan. n-c.kaji@f6.dion.ne.jp
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kajihara
authors.forename: Toshihide
authors.initials: T
authors.lastname: Asou
authors.forename: Yuko
authors.initials: Y
authors.lastname: Takeda
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Kosaka
mesh_terms: D000015:Abnormalities, Multiple / Q000503:physiopathology / Q000601:surgery; D006348:Cardiac Surgical Procedures; D002648:Child; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D013577:Syndrome; D016896:Treatment Outcome