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Computed tomography imaging of coronary artery abnormality: left coronary artery from the trunk of the pulmonary artery


Authors: Makarenko V.N., Pirogova M.A., Shlyappo M.A.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Heading: Clinical Cases

UDC: 616.13/.14

Link: Clinical Physiology of Blood Circulaiton. 2019; 4 (3): 277-279

Quote as: Makarenko V.N., Pirogova M.A., Shlyappo M.A. Computed tomography imaging of coronary artery abnormality: left coronary artery from the trunk of the pulmonary artery. Cardiovascular Surgery News. 2019; 3 (4): 277–9 (in Russ.). DOI: 10.24022/ 2588-0284-2019-3-4-277-279

Received / Accepted:  19.11.2019 / 02.12.2019

Full text:  


Abstract

Bland-White-Garland Syndrome (BWGS) is a congenital heart disease in which an abnormal discharge of the left coronary artery from the trunk of the pulmonary artery is noted. The debut of the development of myocardial ischemia is determined by the dependence of the balance between the rate of closure of the open arterial duct (pressure reduction in LA) and the rate of development of intercoronary anastomoses. First, ischemia occurs periodically, manifesting itself only with an increase in oxygen consumption by the myocardium, for example during feeding or severe anxiety – “feeding angina pectoris”. Then the manifestations of myocardial infarction progress, and perfusion disorders can be so serious that mechanical complications occur. In a very large percentage of cases, BWGS may not manifest itself clinically and make its debut as a myocardial infarction or sudden cardiac death amid the development of life-threatening ventricular arrhythmias. In addition, BWGS has “masks” of other diseases, such as myocarditis, postmyocarditis cardiosclerosis, dilated cardiomyopathy, prolapse and/or mitral valve insufficiency.

In connection with the foregoing, high-tech diagnostic methods, such as computed tomography angiography, which allows you to accurately verify congenital heart disease, are of particular importance.

References

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  2. Бокерия Л.А., Борисов К.В., Синев А.Ф. Оригинальный способ хирургической коррекции гипертрофической обструктивной кардиомиопатии и комплексный подход к ее лечению. Грудная и сердечно-сосудистая хирургия. 1997; S2: 80. [Bockeria L.A., Borisov K.V., Sinev A.F. An original method of surgical correction of hypertrophic obstructive cardiomyopathy and a comprehensive approach to its treatment. Grudnaya i Serdechno-Sosudistaya Khirurgiya (Russian Journal of Thoracic and Cardiovascular Surgery). 1997; S2: 80 (in Russ.).]

About Authors

Vladimir N. Makarenko, Dr. Med. Sc., Professor, Head of Department, orcid.org/0000-0002-8700-7592

Marina A. Pirogova, Cand. Med. Sc., Radiologist, orcid.org/0000-0002-9883-7276

Mariya A. Shlyappo, Cand. Med. Sc., Radiologist, orcid.org/0000-0001-6264-8919


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