Surgical correction of congenital malformations of the coronary circulation.

Although a number of congenital malformations of the coronary circulation have been recognized for many years, only in the recent past have these been diagnosed and surgically corrected. These lesions include origin of the left coronary artery from the pulmonary artery, coronary arterial fistulas, coronary arterial aneurysms, origin of the right coronary artery from the pulmonary artery, and membranous obstruction of the ostium of the left main coronary artery. Specific symptom complexes and complications are apt to be associated with each of these conditions. Coronary arteriography is usually diagnostic, and surgical correction is indicated in many instances to prevent serious and often fatal complications. The clinical manifestations, physical findings, diagnosis, and management of these lesions are reviewed. Fortunately, the surgical results are usually quite good.