Origin of both coronary arteries from the pulmonary artery

• Published in: Circulation (New York, N.Y.) Vol. 90; no. 5; pp. 2379 - 2384
• Main Authors: URCELAY, G. E, IANNETTONI, M. D, LUDOMIRSKY, A, MOSCA, R. S, CHEATHAM, J. P, DANFORD, D. A, BOVE, E. L
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.11.1994; American Heart Association, Inc
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Coronary Vessel Anomalies - surgery; Female; Heart; Humans; Infant; Male; Medical sciences; Pulmonary Artery - abnormalities; Case study; Human; Treatment; Radiodiagnosis; Angiography; Anomalous origin of the coronary artery; Congenital; Heart disease; Surgery; Cardiovascular disease; Technique; Pulmonary artery
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.90.5.2379

Origin of both coronary arteries from the pulmonary artery is generally a lethal condition from progressive ventricular failure. We report the clinical and surgical course of two infants, ages 3 and 6 months, with this anomaly. One patient had normal intracardiac anatomy with low pulmonary artery pressures (30/12 mm Hg). The second patient had a restrictive subpulmonic ventricular septal defect with a moderately elevated pulmonary artery pressure (50/13 mm Hg). Left ventricular ejection and shortening fractions were profoundly depressed in both patients. The common coronary trunk arose from the right anterior facing sinus in one patient and from the left posterior facing sinus in the other. Both patients underwent repair by direct coronary implantation to the aorta. Left ventricular function improved with shortening fractions near normal at a follow-up of 6 months for one patient and 1 year for the other. Early diagnosis and prompt repair is compatible with survival and return of normal shortening fraction.