Anomalous origin of the left circumflex artery from the pulmonary artery associated with non-compaction of the left ventricle: usefulness of multimodality imaging—a case report

Abstract

Introduction Anomalous origin of the left circumflex artery from the pulmonary artery (ACXAPA) is a very rare coronary anomaly. Only a few cases have been reported until today, from incidental findings to autopsy report after sudden cardiac death. Case We report here for the first time the case of a man, previously monitored for asymptomatic left ventricular non-compaction cardiomyopathy (LVNC), who presented with non-ST myocardial infarction, and was diagnosed with ACXAPA. Complementary tests confirmed ischemia in the corresponding territory and the patient was referred to surgery for reimplantation of the circumflex artery. Discussion LVNC is a rare congenital cardiomyopathy whose association with coronary anomalies, but not with ACXAPA, had previously been described until now. A related embryological origin could potentially explain this association. The management of a coronary anomaly should indicate dedicated multimodal cardiac imaging in order to not disregard the association with an underlying cardiomyopathy.

Anomalous origin of the circumflex artery from the right pulmonary artery

“…Diagnosis is established with direct visualization of the coronary circulation, either by catheter or CT angiography [ 1 , 2 , 4 , 5 ]. Only a handful of case reports describing patients with ACxAPA have been published, most of which have had additional congenital defects [1] , and fewer in which ACxAPA was the only cardiovascular defect [ 6 , 7 ].…”

Discovery and functional investigation of BMP4 as a new causative gene for human congenital heart disease

“…Notably, if minor cardiac developmental aberrations are encompassed, such as patent foramen ovale and aortic bicuspid valve, the prevalence of CHD rises to around 5% of all live births [4][5][6]. As an array of cardiovascular developmental deformations, CHD is clinically categorized into > 30 distinct isoforms, encompassing double-outlet right ventricle (DORV) and ventricular septal defect (VSD) [2,[7][8][9][10][11][12][13][14]. Though certain mild/minor forms of CHD may resolve spontaneously [2], severe/complex forms of CHD usually lead to worse quality of life [15][16][17], reduced exercise performance [18][19][20][21], neurodevelopmental delay and structural brain anomaly [22][23][24][25][26], ischemic/thromboembolic stroke [27,28], acute renal injury/chronic kidney disease [29][30][31][32], hepatic fibrosis [33,34], pulmonary dysplasia/ pulmonary arterial hypertension [35][36][37], bacte-Am J Transl Res 2024;16 (5):2034-2048 rial endocarditis [38][39][40][41][42], chronic heart failure …”