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Anesth Analg 2007;104:81-83
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000250365.25480.c5

PEDIATRIC ANESTHESIA

Unrecognized Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery as a Cause of Ventricular Fibrillation After Patent Ductus Arteriosus Ligation in an Infant

Elena Bafani, MD, Avinash C. Shukla, MD, and James A. DiNardo, MD

From the Department of Anesthesia, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts.

Address correspondence and reprint requests to Elena Bafani, MD, Department of Anesthesia, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115. Address e-mail to elena.bafani{at}childrens.harvard.edu.

We present a case of an infant who developed ventricular fibrillation after patent ductus arteriosus (PDA) ligation. The infant had unrecognized anomalous origin of the left coronary artery from the pulmonary artery before PDA ligation. Acute reduction in systemic pulmonary artery pressures after PDA ligation resulted in an abrupt reduction in left main coronary artery blood flow. After prompt resuscitation, cardiac catheterization confirmed the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery. The infant subsequently underwent coronary artery translocation and recovered uneventfully.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.