A curious course of an intramural anomalous left coronary artery from the pulmonary artery

Abstract

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac malformation accounting for approximately 1 in 300,000 live births. 1 The first reported child with ALCAPA was described by Russian pathologist Alexei Ivanovich Abrikosov in 1911, when he described postmortem ''a left ventricular aneurysm with anomalous origin of the left coronary artery from pulmonary artery in a 5-month old child.'' 2 A comprehensive clinical description was given in 1933 by American physicians Edward Bland, Paul Dudley White, and Joseph Garland. 3 Thus, a typical clinical presentation is often referred to today as Bland-White-Garland syndrome.

Intramural Aortic Course Should Always Be Considered for Anomalous Origin of the Left Coronary Artery From the Right Pulmonary Artery

“…So, a high index of suspicion and vigilance is required while dealing with ALCARPA, recognizing the high probability of intramural aortic course. We agree with Naimo et al 15 who suggested to always suspect an intramural segment in cases of ALCARPA, to avoid damage to the intramural segment.…”

Anomalous Left Coronary Artery from the Pulmonary Artery: Mini-Review

“…This is a highly exceptional association. And, the literature is limited to a few case reports and small series [1].…”

“…In their original report, pathological review of nine cases of ALCAPA was presented. [1]. ALCAPA is among the frequent causes of myocardial ischemia and infarction in children with a mortality rate of 90% if early intervention is not initiated.…”

Anomalous Left Coronary Artery Arising from the Pulmonary Artery (ALCAPA): The Critically Important Role of Color Flow Doppler in Identifying a Rare Intramural Course

“…The addition of an intramural aortic course is exceedingly rare, with the literature limited to case reports. [5][6][7][8] One center encountered only one case with intramural aortic course out of 42 total ALCAPA repairs over a 35-year experience. 9 Even when ALCAPA was detected on preoperative imaging, failure to recognize the intramural aortic course has led to accidental injury of the LCA.…”