Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in adults: Collateral circulation does not preclude direct reimplantation

Cavalcanti, Luiz Rafael Pereira; Neto, Amadeu Lombardi; Salerno, Pedro Rafael; Lima, Ricardo Carvalho

doi:10.1111/jocs.15238

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…In this study, no significant differences in the recovery of ventricular function existed among the three groups. After ALCAPA repair, the left ventricular function of most patients returned to normal regardless of concomitant mitral valve intervention, which is similar to that reported in most literature ( 19 – 21 ). In addition, we found that the left ventricular diameter of most patients improved significantly before discharge, and the LVEF did not improve immediately.…”

Section: Discussionsupporting

confidence: 87%

Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve

Ren

Liu

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveUse of concomitant mitral valve repair remains controversial in the anomalous left coronary artery from the pulmonary artery (ALCAPA) with mitral regurgitation (MR). This study aimed to evaluate postoperative mitral valve function and explore the indication for concomitant mitral valve repair.Materials and methodsThe medical records of 111 patients with ALCAPA and MR who underwent ALCAPA surgery between April 2006 and November 2020 were reviewed. The patients were categorized into three groups for comparison, namely, group I consisted of 38 patients with trivial or mild MR who underwent ALCAPA repair only; group II consisted of 37 patients with moderate or severe MR who similarly had only surgery of the ALCAPA performed; and group III consisted of 36 patients who had concomitant mitral valve repair for moderate or severe MR.ResultOverall mortality was 7.2% (8 of 111). The mortality of group II (16.2%, 6 of 37) was higher than those of groups I (5.3%, 2 of 38) and III (0%, 0 of 36) (p = 0.027). All three patients who underwent mitral valve reintervention were in group II. At the last follow-up, none of the patients had more than moderate MR in group I. The percentage of patients with improved MR grade was 79.4% (27 of 34) in group III and 51.4% (19 of 37) in group II (p = 0.001). The multivariate logistic regression revealed that concomitant mitral valve repair (adjusted odds ratio = 4.492, 95% CI: 1.909–12.794; p < 0.001) was the major factor influencing MR grade improvement.ConclusionThe long-term outcomes after ALCAPA repair were favorable. For mild MR, ALCAPA repair only can be performed. For moderate and severe MR, we suggest concomitant mitral valve repair.

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Section: Discussionsupporting

confidence: 87%

Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve

Ren

Liu

et al. 2022

Front. Cardiovasc. Med.

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“…ALCAPA classically presents with symptoms of heart failure secondary to ischemia in an extensive myocardial territory (5,6). The age of presentation depends on the number and quality of collaterals from the right coronary system to meet myocardial demands (7).…”

Section: Discussionmentioning

confidence: 99%

ALCAPA syndrome: an unexpected cause of severe mitral regurgitation in an adult

Largo

Garcia

Lopez

et al. 2023

Preprint

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Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually manifests in childhood and has a high mortality rate in the first year of life if not corrected. We present the case of a middle-aged woman who presented with exertional dyspnea and severe ischemic mitral regurgitation; further imaging revealed it was secondary to ALCAPA. The patient was referred for valvular reconstruction and surgical revascularization with left coronary artery reimplantation in the aorta. The patient had an adequate postoperative result and symptomatic improvement during follow-up. Although ALCAPA is a rare cause of mitral regurgitation in adults, its pathophysiology is like that of ischemic origin from atherosclerotic coronary disease, and its treatment is therefore similar to obtain adequate clinical improvement.

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“…The arising of the left common coronary artery (LCCA) from the PA (ALCAPA), known as Bland-White-Garland syndrome, was first described in 1933 [5][6][7]. This disease represents 0.24-0.46% of all congenital heart malformations, which represents an incidence of 1 in 300,000 [1,4,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of anomalous origin of the right coronary artery (RCA) from the pulmonary artery (PA) (ARCAPA) is 1 in 500,000 and was first described in 1882 by John Brook [1]. It represents 0.12% of all congenital heart diseases [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The lower incidence of ARCAPA in comparison with ALCAPA is caused by the higher intimacy of the left common coronary artery (LCCA) origin to the PA sinus [6].…”

Section: Introductionmentioning

confidence: 99%

Anomalous Arising of Right Coronary Artery from the Pulmonary Artery

Kolesár,

Toporcer,

Čobejová

et al. 2024

JCDD

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Coronary artery anomalies are seen in less than 1% of the general population and in 1.6% of cardiac catheterization cases. The anomalous origin of the coronary artery from the pulmonary artery is one of four groups of coronary artery origin anomalies. The incidence of anomalous origin of the right coronary artery from the pulmonary artery is 1 in 500,000 and was first described in 1882 by John Brook. This case report reports on a 67-year-old man with a diagnosis of asymptomatic anomalous origin of the right coronary artery from the pulmonary artery. The patient underwent surgery of the aortic valve because of valve stenosis. A concomitant surgical procedure included repositioning of the right coronary artery origin to the aortic root sinus. The patient was discharged on the 12th postoperative day, in good condition. Anomalous origin of the right coronary artery from the pulmonary artery is commonly asymptomatic, and surgery is required only if myocardial ischemia is presented.

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in adults: Collateral circulation does not preclude direct reimplantation

Cited by 7 publications

References 10 publications

Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve

Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve

ALCAPA syndrome: an unexpected cause of severe mitral regurgitation in an adult

Anomalous Arising of Right Coronary Artery from the Pulmonary Artery

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