Anomalous left coronary artery from the pulmonary artery (ALCAPA) was described by Abbott in 1908. In most cases, it is an isolated lesion, being the most common cause of myocardial ischemia in children. The associated mortality rate without intervention reaches 90% during childhood. We report the case of a 67-year-old woman, who underwent coronary angiography for investigation of atypical chest pain and was found to have ALCAPA. The patient refused surgery and has remained asymptomatic on a medical regimen.
We report the case of 50 year-old woman who presented with left ventricle outflow tract obstruction with discrete sub-aortic membrane 20 years following mitral valve replacement and tricuspid valve annuloplasty. We aim through this case, on one hand to report this unusual entity and on the other hand to discuss the underlying mechanisms as well as the therapeutic solutions.
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