TITLE: A long-term survivor of Bland-White-Garland syndrome with systemic collateral supply. A case report and review of the literature. AUTHORS:

Anomalous origin of the left coronary artery arising from the pulmonary artery (Bland-White-Garland syndrome also known as ALCAPA syndrome), is a rare congenital abnormality affecting 1 in 300.000 live births, accounting for 0,5% of cases of congenital heart disease [1]. Patients with Bland-White-Garland (BWG) syndrome who survive past childhood often have varying symptoms of myocardial ischaemia, impaired left ventricular function, mitral regurgitation and progressive heart failure, depending on the development of collateral circulation. The majority of patients die in infancy [2]. A case of a 45-year-old woman referred to our institution with the diagnosis of mitral regurgitation is presented. Detailed diagnostics revealed BWG syndrome. Subsequent therapy consisted of ligation of the anomalous origin of the left coronary artery, anastomosis of left internal mammary artery (LIMA) to the left anterior descending (LAD) branch and mitral valve replacement with a mechanical prosthesis.