[Left coronary artery originating from the pulmonary artery as a syndrome found in infancy, childhood and adulthood].

The cases of two patients with Bland-White-Garland-Syndrome are reported. A 13 year old girl had been operated during infancy (ligation of the left coronary artery at its origin from the pulmonary artery) and showed reopening of the ligation with marked collateral circulation between the right and left coronary artery. She was operated again, successfully. A second critically ill patient with a typical pattern of anterolateral infarction in his ECG recovered so well that only five years later he was readmitted; then he showed the adult-type ECG with good collateral circulation between the right and left coronary artery. He underwent an equally successful operation. In both cases there is good evidence for the development of a sufficient collateral circulation after ligation of the coronary artery to pulmonary artery connection. Spontaneous formation of anastomoses between the right and left coronary artery enables even infants with this anomaly to survive. These findings confirm the suggestion that the "infancy-type" and "adult-type" of the Bland-White-Garland-Syndrome represent only different stages of the same disease.