Bland-White-Garland syndrome. Surgical treatment using a minimal-invasive approach

We report the surgical treatment of a Bland-White-Garland syndrome (BWG-syndrome) of adult type in a 61-year old female patient. Coronary catheterization revealed an anomalous origin of the left coronary artery from the trunk of the pulmonary artery. Based on excellent collateral perfusion of the artery from the right coronary artery, ligation near its origin from the pulmonary artery was attempted via a minimally-invasive approach. No saphenous vein bypass was implanted, no reimplantation of the anomalous vessel in the aorta was performed. The patient recovered uneventfully without signs of ischemia. Appearance of BWG-syndrome in adults is very rare, especially without symptoms of myocardial ischemia. The different modalities of the treatment of these syndromes in adult patients are often debated. In this case, closure without revascularisation appeared to be appropriate.