Anomalous origin of circumflex coronary artery from right pulmonary artery in a hypoplastic left heart syndrome child

Jaworski, Radosław; Kansy, Andrzej; Łaniewski-Wołłk, Przemysław

doi:10.5114/kitp.2014.43853

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…The available literature presents only a few descriptions of patients with HLHS and ALCAPA; in the vast majority of cases, such patients did not live beyond the first postoperative day [1, 2]. …”

mentioning

confidence: 99%

Hypoplastic left heart syndrome with anomalous circumflex artery arising from left pulmonary artery. A description of combined surgical and interventional cardiac treatment

Gładki

Mroczek²,

Czerżyńska

et al. 2018

pwki

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mentioning

confidence: 99%

Hypoplastic left heart syndrome with anomalous circumflex artery arising from left pulmonary artery. A description of combined surgical and interventional cardiac treatment

Gładki

Mroczek²,

Czerżyńska

et al. 2018

pwki

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“…The combination of these anomalies has been described in the literature; however, the prevalence of such a condition is unknown. [1][2][3][4][5][6] Being able to recognise it and deal with it intraoperatively is very challenging. We report the case of a neonate with a univentricular heart in the form of a double-outlet right ventricle, mitral atresia with discrete coarctation of the aorta, and an incidental intraoperative finding of an anomalous origin of the left coronary artery from the right pulmonary artery who underwent a successful surgical repair.…”

Section: A Nomalous Origin Of the Left Coronarymentioning

confidence: 99%

“…Most cases were associated with hypoplastic left heart syndrome. 2,[4][5][6] One study described a double-outlet right ventricle with mitral atresia and a left circumflex artery from the right pulmonary artery. 3 Other case reports described the anomalous artery to be originating from the main pulmonary artery rather than from its branches.…”

Section: Commentmentioning

confidence: 99%

“…It has been shown that the intraoperative recognition of this anomaly after instituting cardiopulmonary bypass will most likely lead to adverse outcomes and eventually death. 1,3,5,6 Only one case has been reported in the literature in which the patient survived after bypass initiation and intraoperative recognition. 4 Unfortunately, the preoperative CT angiogram for this patient was misinterpreted by both the radiologist and the surgeon and the correct diagnosis was missed.…”

Section: Commentmentioning

confidence: 99%

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Anomalous origin of the left coronary artery from the right pulmonary artery in a univentricular heart

2017

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Anomalous origin of the left coronary artery from the right pulmonary artery in single ventricles is a very rare congenital anomaly. Failure to recognise it preoperatively may lead to adverse outcomes, including death. We report the case of a neonate with a univentricular heart in the form of a double-outlet right ventricle, mitral atresia with discrete coarctation of the aorta, and an incidental intraoperative finding of an anomalous origin of the left coronary artery from the right pulmonary artery. The patient underwent a successful repair with an uneventful postoperative course.

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“…ARCAPA is potentially life threatening due to its consequential conditions such as coronary ischemia, heart failure, and sudden cardiac death (in infancy/adolescence/adulthood due to fatal arrhythmia) [3]. This defect is also known to pose as a challenge during surgical procedures, usually because it is incidentally diagnosed in the operation room [4]. Most patients with ARCAPA are asymptomatic and sometimes the anatomical defect may be subtle and thus difficult to visualize.…”

Section: Introductionmentioning

confidence: 99%

Anomalous Origin of a Right Coronary Artery from Pulmonary Artery

Rawala

Naqvi

Farhan

et al. 2018

Case Reports in Cardiology

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Congenital defects of the coronary arteries are noted in 0.2–1.4% of the general population. The first case of an anomalous origin of right coronary artery from pulmonary artery (ARCAPA) was described by Brooks in 1885. ARCAPA has an overall incidence of 0.002% in the general population. Most of the cases are asymptomatic; however, it can lead to serious complications such as heart failure, ischemia, and sudden death. A 57-year-old man presented to the cardiologist's office with complaints of shortness of breath and fatigue. The patient also had a previous history of coronary stents and heart failure. Initially, he was evaluated with a stress test which was reported as abnormal. The patient then underwent an invasive coronary angiography that revealed anomalous origin of the right coronary artery (RCA) and multivessel disease. Cardiothoracic surgery evaluated the patient and coronary artery bypass graft was performed. During the surgery, the anomalous origin of RCA from the pulmonary artery was identified and was successfully corrected by reimplanting the RCA into the ascending aorta. The anomalous origin of RCA is a rare yet life-threatening condition. The RCA due to its location of origin from the pulmonary artery tends to be a low-pressure vessel with a very thin and fragile wall. It also serves as a retrograde venous conduit from the left coronary circulation into the pulmonary artery. This connection results in a left-to-right shunt that explains the increase in oxygen saturation in the pulmonary artery and the high cardiac output which is normally seen in these cases. The clinical presentation can vary from coronary ischemia to heart failure or sudden death. Therefore, surgical correction is recommended even in asymptomatic patients. We present a case of an anomalous origin of RCA from the pulmonary artery which, unlike the origin of left coronary from pulmonary artery, is very rare. Patients with this condition should have early correction even if they are asymptomatic in order to prevent long-term complications.

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Anomalous origin of circumflex coronary artery from right pulmonary artery in a hypoplastic left heart syndrome child

Cited by 6 publications

References 10 publications

Hypoplastic left heart syndrome with anomalous circumflex artery arising from left pulmonary artery. A description of combined surgical and interventional cardiac treatment

Hypoplastic left heart syndrome with anomalous circumflex artery arising from left pulmonary artery. A description of combined surgical and interventional cardiac treatment

Anomalous origin of the left coronary artery from the right pulmonary artery in a univentricular heart

Anomalous Origin of a Right Coronary Artery from Pulmonary Artery

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