Myocardial Ischemia after Ligation of an Anomalous Left Coronary Artery Arising from the Pulmonary Artery

Abstract

ALTHOUGH origin of the left coronary artery from the pulmonary artery is not a newly recognized anomaly, until recent years the direction of blood flow in this particular anatomic condition was a matter of dispute. Brooks,¹ in 1886, suggested the presence of a left-to-right shunt on the basis of postmortem examination in 2 cases. Later, Abbott² and, more recently, Edwards³ have emphasized the probable retrograde flow from coronary artery to pulmonary artery. A left-to-right shunt has now been clearly demonstrated by cardiac catheterization and retrograde angiography.^{4 5 6 7} The direction of the shunt has also been shown on the operating table.⁸ Because . . .