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Thallium-201 Myocardial SPECT in Bland-White-Garland Syndrome: Two Adult Patients with Inferoposterior Perfusion Defect

Departments of Radiology, Cardiology and Thoracic Surgery, St. Mary's Hospital, Kurume, Japan

Correspondence: For correspondence or reprints contact: Makoto Katsuragi, MD, Department of Radiology, St. Mary's Hospital, 422 Tsubuku-honmachi, 830 Kurume, Japan.

ABSTRACT

A myocardial ²⁰¹Tl SPECT examination was conducted both prior to and following surgery of two adult patients with an anomalous left coronary artery originating from the pulmonary artery (Bland-White-Garland syndrome). In this syndrome, the anterior wall is usually affected first. Preoperative examination demonstrated an inferoposterior perfusion defect. In both patients, the right coronary artery was markedly dilated, and a significant left-to-right shunt formation was observed. Both patients were diagnosed as possibly having coronary steal syndrome. A prolonged inadequate blood supply to the right coronary region may cause inferoposterior cardiomyopathy. In the postoperative examination, myocardial perfusion markedly improved in one patient whose preoperative SPECT showed redistribution in a delayed scan. Thallium-201 SPECT was therefore found to be useful in assessing both the preoperative and postoperative myocardial perfusion.

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				T. Tashiro and K. Todo Anomalous origin of the left coronary artery from the pulmonary artery J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1147 - 1148. [Full Text]