Adult type anomalous origin of the left coronary artery from the pulmonary artery: When should we be aware?

Drighil, A.; Chraibi, Saïd; Bennis, Ahmed

doi:10.1016/j.ijcard.2006.07.039

Cited by 7 publications

(11 citation statements)

References 10 publications

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“…However, even these patients will become symptomatic over time, as the flow in the anomalous coronary will reverse and the phenomenon of coronary steal may occur 4 . Sudden cardiac death may be the initial presentation of ALCAPA syndrome 1–4 …”

Section: Discussionmentioning

confidence: 99%

“…Some echocardiographic findings are highly suspicious of this syndrome, such as a dilated RCA arising from the aorta, a continuous blood flow from the LCA into the pulmonary artery, and the visualization of dilated interventricular septal collaterals. However, these findings are most often detected in children because of their better acoustic windows 1–3 . Multidetector computed tomographic angiography and magnetic resonance enables accurate noninvasive imaging of coronary artery and their anomalies.…”

Section: Discussionmentioning

confidence: 99%

“…Coronary artery bypass surgery and ligation of the anomalous LCA are reserved for those patients in whom coronary reimplantation is not technically feasible 7,9,10 . If left untreated, the mortality of ALCAPA syndrome is more than 90% within the first year of life 3,7 …”

Section: Discussionmentioning

confidence: 99%

“…Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare congenital anomaly, corresponding to 0.25–0.5% of congenital heart diseases 1,2 . More than 90% of patients with this condition have symptoms or die within the first year of life as a result of myocardial ischemia that leads to ventricular dysfunction, mitral regurgitation, and congestive heart failure 3 . However, when a well‐developed network of collaterals between the right coronary artery (RCA) and the LCA is present, patients may remain asymptomatic until adulthood 2 .…”

Section: Introductionmentioning

confidence: 99%

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Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in an Asymptomatic Adult

Lopes¹,

Almeida²,

Amorim

et al. 2011

Congenital Heart Disease

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Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly with a mortality of 90% in the first year of life, if not surgically corrected. Adult presentation of the anomalous origin of the left coronary artery from the pulmonary artery syndrome is extremely rare but may occur if a well-developed collateral circulation from right coronary artery is present. We present the case of a 22-year-old asymptomatic female with anomalous origin of the left coronary artery from the pulmonary artery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in an Asymptomatic Adult

Lopes¹,

Almeida²,

Amorim

et al. 2011

Congenital Heart Disease

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show abstract

“…Also, cardiomyopathy or myocarditis may be misdiagnosed because of poorly contractile left ventricle [1]. Hence, enhancing the knowledge and awareness of ALCAPA is important for cardiovascular pediatricians and echocardiographic technicians [16].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of parasternal pulmonary artery short-axis view for the anomalous origin of the left coronary artery from the pulmonary artery

Jiang

Wang

Gong

et al. 2014

Journal of Cardiology

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The 64-Multislice Computed Tomogram Averts Misdiagnosis of an Anomalous Origin of the Left Main Coronary Artery

et al. 2009

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A 38-year-old woman was discovered to have a systolic murmur for an unrelated complaint. Transesophageal echocardiography showed no atrial or ventricular septal defects, but multiple large collateral vessels in interventricular septum. The origin of left coronary artery was not seen at the expected site on the aortic root. The 64-multislice computed tomography confirmed the diagnosis of an anomalous origin of the left coronary artery from the pulmonary artery. Left coronary artery was revascularized with a saphenous vein graft with an uneventful recovery.Keywords Anomalous origin of the left coronary artery from the pulmonary artery Á Multislice Á Computed axial tomography During physical examination, a 38-year-old woman was found to have an asymptomatic systolic murmur. The electrocardiogram was normal, and the chest radiograph showed mild cardiomegaly. Transthoracic echocardiography showed a moderately decreased systolic function (ejection fraction = 35%), no mitral regurgitation, and multiple muscular ventricular septal defects (VSDs), i.e., a possible ''Swiss cheese'' VSD. In contrast, the transesophageal echocardiogram showed no atrial or ventricular septal defects; instead, there were multiple large collateral vessels in the interventricular septum. Because the origin of the left coronary artery (LCA) was not visualized, and to better clarify the anatomy, a contrast-enhanced 64-multislice computed tomogragraphy (MSCT) was performed. The tomogram showed a dilated and tortuous right coronary artery arising from the right sinus of Valsalva and giving off extensive collateral vessels coursing over the right ventricular wall, the interventricular septum, and the apex to the LCA that originated from the proximal main pulmonary artery (Fig. 1a-c). Therefore, the diagnosis of anomalous origin of the LCA from the pulmonary artery (ALCAPA) was confirmed. Technically, transfer of the LCA from the PA was not feasible; thus, the LCA coronary origin was oversewn and a saphenous vein graft from the aorta to the LCA was performed. The patient's postoperative course was uneventful.

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Adult type anomalous origin of the left coronary artery from the pulmonary artery: When should we be aware?

Cited by 7 publications

References 10 publications

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in an Asymptomatic Adult

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in an Asymptomatic Adult

Diagnostic value of parasternal pulmonary artery short-axis view for the anomalous origin of the left coronary artery from the pulmonary artery

The 64-Multislice Computed Tomogram Averts Misdiagnosis of an Anomalous Origin of the Left Main Coronary Artery

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