Preview

Yakut Medical Journal

Advanced search

Bland-White-Garland syndrome: clinical features of the course and treatment in young patients

https://doi.org/10.25789/YMJ.2024.88.29

Abstract

Bland-White-Garland syndrome (SBUG) is a rare, high–risk fatal outcome in infancy and sudden death in adults, an anomaly of the divergence of the left coronary artery (LCA) from the pulmonary artery (PA) (ALCAPA - abnormal left coronary artery arising from the pulmonary artery). In 85- 90% of cases, children without radical surgical treatment do not live up to a year. In our clinical case, in a 36-year-old patient, the disease debuted with recurrent ventricular arrhythmias, Imaging diagnostic methods coronary angiography, spiral computed tomography, magnetic resonance imaging of the heart revealed in the patient, in addition to the pathology of the LCA, individual anatomical features of the coronary bed, which provided adequate myocardial perfusion and maintained sufficient myocardial reserve. A combined operation was performed on a patient at the "Federal Center for Cardiovascular Surgery" of Khabarovsk: prosthetics of the LCA trunk with a vascular prosthesis "Vascutek PTFE" № 6. Plastic surgery of the pulmonary trunk (PT) with a patch from the autopericardium. Mitral valve repair (MV) on the "MedInj" support ring № 28. The postoperative period was uneventful. The period of dynamic observation was 22 months. Currently, the patient is in a satisfactory condition and is able to work. Given the different clinical variants of SBUG, specialists providing primary health care - district pediatricians, internists, cardiologists - should be wary of this rare but life-threatening congenital malformation.

About the Authors

A. M. Palshina
Медицинский институт Северо-Восточн. федеральн. ун-та им. М.К. Аммосова
Russian Federation


N. N. Silina
Респ. кардиососуд. центра Респ. б-цы №1–Национальн. центра медицины им. М.Е. Николаева
Russian Federation


A. B. Okorokova
РКЦ РБ №1-НЦМ
Russian Federation


K. I. Ivanov
РКЦ РБ№1-НЦМ
Russian Federation


E. V. Rosseykin
Федеральн. центр сердечно-сосуд. хирургии МЗ РФ
Russian Federation


E. E. Kobzev
Федеральн. центр сердечно-сосуд. хирургии
Russian Federation


A. I. Borisov
МИ СВФУ
Russian Federation


V. A. Gogolev
МИ СВФУ
Russian Federation


References

1. Bokeria, L. A., Ivashchenko, D. K. BlandWhite-Garland syndrome: etiopathogenetic features of mechanical complications // Children's heart and vascular diseases. 2016; 13(1):23-32.

2. Galagudza M.M., Sonin D.L., Aleksandrov I.V. Myocardial hibernation: molecular mechanisms, clinical significance and diagnostic methods// Regional blood circulation and microcirculation. 2019;18(3):9-15. https://doi.org/10.24884/1682-6655-2019-18-3-9-15.

3. A clinical case of abnormal divergence of the left coronary artery from the trunk of the pulmonary artery (Bland-White-Garland syndrome) in an adult patient / Povorozny A.O., [et al]. // Complex problems of cardiovascular diseases. 2022;3:199-203.

4. A rare case of Bland-White-Garland syndrome in an adult patient. / Alekseeva, Y. M., [et al]. // Cardiology. 2012;11:4-14.

5. The role of extra- and intracardial collateral circulation in patients with chronic coronary artery disease. / Shevchenko Y.L., [et al] // Bulletin of the National Medical and Surgical Center named after N. I. Pirogov. 2018;13(4):10-17.

6. Abrikossoff A. Aneurysma des linken Herzventrikels mit abnormer Abgangsstelle der linen Koronararterie von der Pulmonalis bei einem fünfmonatlichen Kinde. Virchows Arch. path Anat. 1911;203:413-420.

7. ALCAPA in adult asymptomatic patient: A case report. / Talkhatova S. [et al]. // Int J Surg Case Rep. 2023;109:108521. doi: 10.1016/j.ijscr.2023.108521.

8. Bland E.F., White P.D., Garland J. Congenital anomalies of the coronary arteries: report of an unusual case associated with cardiac hypertrophy // Am Heart J:8(6),787-801. doi: 10.1016/S0002-8703(33)90140-415.

9. Case report of asymptomatic very late presentation of ALCAPA syndrome: review of the literature since pathophysiology until treatment / Cambronero-Cortinas E. [et al] // Eur Heart J Case Rep. 2020;4(5):1-5. doi: 10.1093/ehjcr/ytaa257.

10. Keng-Yi Wu., Shu-meng Cheng. An extremely rare case of anomalous origin of the left coronary artery from the pulmonary artery concomitant with noncompaction of the ventricular myocardium in a half marathon runner // International Research Journal of Medicine and Biomedical Sciences. 2020;5(2):13-18.


Review

For citations:


Palshina A.M., Silina N.N., Okorokova A.B., Ivanov K.I., Rosseykin E.V., Kobzev E.E., Borisov A.I., Gogolev V.A. Bland-White-Garland syndrome: clinical features of the course and treatment in young patients. Yakut Medical Journal. 2024;(4):122-124. (In Russ.) https://doi.org/10.25789/YMJ.2024.88.29

Views: 21


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1813-1905 (Print)
ISSN 2312-1017 (Online)