Subclavian-coronary artery anastomosis. A technique for definitive correction of anomalous origin of left coronary artery.

A case of anomalous origin of the left coronary artery from the pulmonary artery in a 5-year-old child is presented. Surgical correction by means of a direct subclavian-coronary anastomosis was performed at normothermic temperatures without cardiopulmonary bypass. Pre- and postoperative studies including angiography are presented. The rationale for this approach and its benefits are compared to previously utilized surgical techniques. We feel that this method is superior in that it creates a two-coronary system without utilizing prosthetic or vein bypass grafts. It thus can be used in infancy, allows for future growth and development, and is not subject to the inherent deficiencies of prosthetic or vein grafts. All 4 known cases of subclavian-coronary anastomosis previously reported are discussed.