In our clinic, 3 patients with left coronary artery from the pulmonary artery underwent tunnel (takeuchi) procedure. The first patient (5-years-old) underwent VSD closure and PDA ligation 3 years ago. There was a persisting continous murmur and no improvement in his functional capacity and cardiomegaly after this operation. The second patient (9-month-old and 3.3 kg) with dilated type cardiomyopathy and moderate mitral regurgitation had dyspnea at rest despite aggressive medical treatment. The third (2-month-old and 4 kg) had dilated type cardiomyopathy and severe left ventricular dysfunction. The first patient had an unevenfull postoperative period. He is in good condition with the normalization of cardiomegaly and improved ECG ischemic changes 33 months after operation. The second patient died of staphylococcis menengitis and sepsis on 12th postoperative day. The third patient has also recovered after a problematic postoperative period with prolonged respiratory support. She is in 6th postoperative month and myocardial contractility on echocardiographic control had improved.

In our opinion, tunnel operation with the advantage of using otogenous pulmonary artery tissue with growth capacity may successfully be performed in small infants and children. Clinical condition and left ventricular function after surgical treatment improves in the short term follow-up.