A 2-month-old infant has EKG evidence of myocardial ischemia and echocardiography suggests anomalous origin of the left coronary artery from the pulmonary artery. The following is/are true:

d. If the infant deteriorates, ligation of the coronary at its origin is a viable option

Anomalous origin of the left coronary artery from the pulmonary artery results in reverse flow in the coronary into the lowpressure system as a steal from the coronary circulation. If collaterals from the right coronary develop to allow adequate myocardial perfusion, the disorder is frequently not diagnosed until later in life when a murmur is heard. Selective coronary arteriography is appropriate to define the anatomy and operative repair is undertaken promptly. Ligation of the anomalous coronary can be lifesaving but leaves the child dependent on a single vessel and coronary bypass is preferred.