Anomalous left coronary artery from the pulmonary artery

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Possible communication between left coronary artery and pulmonary artery in a 45-year-old woman with Bland-White-Garland syndrome.

Anomalous left coronary artery from the pulmonary artery (ALCAPA or Bland-White-Garland syndrome or White-Garland syndrome) is a rare congenital anomaly in which the left coronary artery (LCA) branches off the pulmonary artery instead of the aortic sinus.[1] After birth, the pressure in other coronary arteries (namely the RCA) will have a pressure that exceeds the LCA and collateral circulation will increase. This, ultimately, can lead to blood flowing from the RCA into the LCA (retrograde) and into the pulmonary artery, thus forming a left-to-right shunt. [2]

The syndrome is named for Edward Franklin Bland, Paul Dudley White, and Joseph Garland.


  1. ^ "Anomalous left coronary artery from the pulmonary artery". A.D.A.M. Medical Encyclopedia. Retrieved June 9, 2012. 
  2. ^ Crawford, Michael; DiMarco, John; Paulus, Walter (September 24, 2009). Cardiology (3rd ed.). Mosby. p. 229. ISBN 0723434859.