Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in Adults

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Abstract
DURING recent years considerable attention has been directed toward the diagnosis and management of patients with origin of the left coronary artery from the pulmonary artery. The vast majority of patients with this malformation have early onset of signs and symptoms of myocardial ischemia, usually during the first months of life. It has been recognized, however, that in a few patients the collateral circulation arising from the normal right coronary artery is sufficiently extensive to allow survival to adult life. While some of the older patients with this malformation remain asymptomatic for significant periods, others develop signs and symptoms of myocardial ischemia. It is the purpose of this communication to describe our experience in adults with this lesion and to review the reported observations in the literature. Report of Cases Case 1.—A 29-year-old woman was referred to the Duke University Medical Center by Donald H. Tucker, MD, with the history

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