MITRAL INSUFFICIENCY DUE TO ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

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Abstract
An infant and a child with anomalous origin of the left coronary artery from the pulmonary artery have been presented. Each showed evidence of mitral insufficiency as a consequence of ischemic damage to the anterior papillary muscle and supporting myocardium. Changes in projected surgical approach necessitated by this combination have been discussed. Survival of the patient and his suitability for surgery are determined not only by the direction of blood flow in the coronary artery, which is influenced by the pressure in the pulmonary artery as well as by adequacy of collateral circulation, but also by the degree of endomyocardial and mitral valvular damage.

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