Coarctation of aorta with right-sided arch: Surgical correction through right thoracotomyTo the Editor:Coarctation of the aorta with right-sided aortic arch is rare.A search of the surgical literature revealed only six reported cases, none of which were repaired through a right thoracotomy.My colleagues and I treated a 15-month-old girl in 1989.Catheterization showed a supracristal ventricular septal defect with a right-sided aortic arch and a discrete coarctation of the aorta with a IS mm Hg gradient at the origin of an aberrant right subclavian artery.Reactive pulmonary hypertension (65/ 20 mm Hg), mild mitral regurgitation, and a moderately dilated left ventricle were also noted.The pulmonary/systemic flow ratio was 3.2:I.Pulmonary artery banding was done on March 1,1989.The pulmonary pressures were brought to 30/15 mm Hg, with a simultaneous increase of systemic pressure from 50 to 65 mm Hg; oxygen saturations were maintained at 100%.The patient returned for reoperation in November 1989.Repeat catheterization showed that the gradient in the coarcta-
An extremely rare congenital abnormality is reported in which the anterior descending coronary artery (LAD) originates from the pulmonary trunk. The clinical presentation, angiographic findings, and surgical treatment are discussed. This is the only reported case where surgical treatment included ligation of the LAD with internal mammary artery bypass grafting.
