Should we address the course as well as the origin of a translocated anomalous coronary artery?

The identification of an anomalous left coronary artery arising from the pulmonary artery demands urgent surgical attention. Myocardial infarction and ongoing myocardial ischemia are a direct consequence with subsequent left ventricular dysfunction. A modification using a combination of autogenous aortic and pulmonary artery flaps is described, which addresses both the origin and the course of the anomalous coronary artery-until now, a feature not generally considered necessary of repairs involving anomalous left coronary artery arising from the left facing pulmonary sinus. (C) 1998 by The Society of Thoracic Surgeons.