A surgical report of Bland White Garland syndrome

We report a 22-year-old mother of 2 who presented to us with exertional chest pain for 3 years. On coronary angiography she was diagnosed to be suffering from Bland White Garland syndrome (BWGS). She had a giant and grossly tortuous right coronary artery (RCA) forming collaterals with the left coronary artery (LCA), which was draining into the pulmonary artery (PA). Surprisingly, she had no evidence of mitral regurgitation on echocardiography, and she had a preserved left ventricular systolic function. She underwent Takeuchi's repair with uneventful recovery. Postoperative CT angiography revealed adequate reimplantation of the left main coronary artery to the aorta with patent tunnel. On a 6-month follow-up, she is asymptomatic and has an optimal flow through the tunnel to the LCA.