This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by LIKAR, I. Articles by LEWIS, K. B. Search for Related Content PubMed PubMed Citation Articles by LIKAR, I. Articles by LEWIS, K. B.

(Circulation. 1966;33:727.)
© 1966 American Heart Association, Inc.

---

Anomalous Left Coronary Artery Arising from the Pulmonary Artery in an Adult

A Review of the Therapeutic Problem

IVAN LIKAR M.D.¹; J. MICHAEL CRILEY M.D.¹; KENNETH B. LEWIS M.D.¹

¹ From the Departments of Medicine and Radiology, The Johns Hopkins University School of Medicine and the Johns Hopkins Hospital, Baltimore, Maryland.

The 29-year-old woman with anomalous left coronary artery arising from the pulmonary trunk whose case is presented is at the time of writing, the oldest patient on record in whom this condition has been diagnosed during life. The diagnosis was made by aortic cineangiography and confirmed by selective injection of contrast material into the right coronary artery. The collateral pathways between the right and the anomalous left coronary artery were thus defined. Vectorcardiographic and electrocardiographic patterns of anterolateral myocardial infarction with periinfarction block have not been observed in any of the previously reported adults with this type of rare congenital anomaly.

The 27 cases of ligation of the aberrant left coronary artery arising from the pulmonary artery reported in the literature have been reviewed and the results of this operation discussed.

Diagnosis of the anomalous left coronary artery in adult life is possible if it is considered in patients presenting with a continuous murmur at the base and electrocardiographic evidence of myocardial infarction.