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Bland-White-Garland syndrome with ventricular septal defect: late presentation.

Research paper by Noriyoshi N Kajihara, Toshihide T Asou, Yuko Y Takeda, Yoshimichi Y Kosaka

Indexed on: 16 Oct '09Published on: 16 Oct '09Published in: General Thoracic and Cardiovascular Surgery



Abstract

Bland-White-Garland syndrome has been reported generally to occur in an isolated lesion. Here, we report a case of Bland-White-Garland syndrome associated with a ventricular septal defect. Late onset of myocardial ischemia was noted in this patient, which we think is related to increased coronary steal due to regression of pulmonary hypertension caused by narrowing of the ventricular septal defect. At surgery, we temporally occluded the left main coronary trunk to cease the coronary steal phenomenon and augment the left coronary flow. Direct implantation of the left coronary artery and closure of the ventricular septal defect were performed. The postoperative course was excellent with no evidence of myocardial ischemia.