THE ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

Abstract

Considerable variation in origin and distribution of the coronary arteries has been described over the years. One of the most interesting anomalies is that of the left coronary artery arising from the pulmonary artery in a heart without other defects, first described by Abrikosoff in 1911. Cases were reported sporadically in the next twenty years but clinical interest was not aroused until Bland, White, and Garland, in 1933, integrated the clinical and pathological data and recorded an electrocardiogram in an infant dying of this condition. In all, nearly 50 cases have been reported, and the author has had an opportunity of studying 10 more at the Hospital for Sick Children in recent years. Bland et al. reported finding this aberrant left coronary once in 6800 necropsies at the Massachusetts General Hospital over a period of thirty-seven years. In the total group of con- genital heart disease we have found this anomaly to occur in 0 5 per cent of cases. In relating it to child population in the Toronto Heart Registry it appears once in 300,000 children. It is undoubtedly a rare defect but its diagnosis during life is now possible in most cases, and successful surgery appears within reach.