[HSF] anomalus origen left coronary

[edgar manrique]

we have a 68 yo female with double lesion mitral and aortic valve regurgitation and trycuspidea regurgitation and auricular fibrilation, and EF 55 % of LV, and she has a origen of left coronary artery from pulmonar artery trunck, and she hasnt been with myocardila isquemia, our question is : 1. there is surgical indication 2. if is yes so, is necessary for LCA clip or graft with safenus or mamary artery, and how is the myocardial protection in pump ??
thanks
edgar j manrique
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