Should We Address the Course as Well as the Origin of a Translocated Anomalous Coronary Artery?

The identification of an anomalous left coronary artery arising from the pulmonary artery demands urgent surgical attention. Myocardial infarction and ongoing myocardial ischemia are a direct consequence with subsequent left ventricular dysfunction. A modification using a combination of autogenous aortic and pulmonary artery flaps is described, which addresses both the origin and the course of the anomalous coronary artery—until now, a feature not generally considered necessary of repairs involving anomalous left coronary artery arising from the left facing pulmonary sinus.