Congenital atresia of the left main coronary artery: Imaging feature in children

Luo, Xianghong; Li, Zhaojun

doi:10.1111/echo.14469

Cited by 2 publications

(1 citation statement)

References 9 publications

(14 reference statements)

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“…Echocardiogram has good repeatability and is valuable for the diagnosis of LMCAA (7) although it is very difficult to distinguish the origin of coronary especially in infants. It can provide evidence for whether further examination such as angiography or cardiac CTA is needed (8). Some details can be found in echocardiogram, which suggests the abnormality coronary origin.…”

Section: Treatment and Follow-upmentioning

confidence: 99%

Clinical Characteristics of Congenital Atresia of the Left Main Coronary Artery in 12 Children

Xiao-kun

Xiao

et al. 2022

Front. Pediatr.

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BackgroundLeft main coronary artery atresia (LMCAA) is an extremely rare abnormality and only <100 cases have been reported worldwide. We describe the clinical manifestations, imaging features, prognosis, and treatments of LMCAA who were admitted in our department, which aimed to improve the clinical diagnosis and treatments of LMCAA in children.MethodsA retrospective study identified 12 patients diagnosed with congenital left coronary artery atresia at Pediatric Heart Center of Beijing Anzhen Hospital from June 2010 to June 2019. The clinical characteristics, imaging data, and treatment follow-up were analyzed.ResultsAmong the 12 cases, 8 were boys and 4 were girls; the age of onset was 2 months to 2 years old (median age 7 months); the age of diagnosis was 7 months to 6 years old (median age 2 years and 11 months). At the initial diagnosis, there were 4 cases of respiratory tract infection with cardiac murmur, 3 cases of cardiac shadow enlargement, 1 case of recurrent syncope, 2 cases of feeding difficulty with cardiac enlargement, and 2 cases of simple cardiac murmur. In 12 cases of electrocardiogram examination, 7 cases showed pathological Q waves of lead I, AVL and v4–v6; in 12 cases of chest X-ray examination, 8 cases showed cardiac shadow enlargement; in 12 cases of our hospital's first cardiac ultrasound examination, 4 cases were definitely diagnosed, and 8 cases showed the possibility of left coronary artery abnormality; in 5 cases of cardiac coronary CT angiography examination, 2 cases were confirmed, 2 cases reported suspected left coronary artery abnormality, and 1 case did not report abnormality; All cases were definitely diagnosed in 8 cases of angiography. Follow-up was performed from 1 to 8 years; one case died suddenly, one case of syncope after activity was treated by oral medication, 3 cases received open coronary angioplasty and mitral valvuloplasty, recovered well after operation, the rest of the children were treated by oral medication, and the symptoms are stable at present.ConclusionsLeft main coronary artery atresia is difficult to diagnose and can result in heart failure early in life. Timely diagnosis and reasonable treatment are the keys to improve the prognosis.

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Section: Treatment and Follow-upmentioning

confidence: 99%

Clinical Characteristics of Congenital Atresia of the Left Main Coronary Artery in 12 Children

Xiao-kun

Xiao

et al. 2022

Front. Pediatr.

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Coronary Artery Anomalies: Diagnosis & Management

Chandrasekhar,

Woods,

Bennett

et al. 2024

Cardiology in Review

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Coronary artery anomalies encompass a spectrum of congenital abnormalities affecting the origin, course, or termination of the major epicardial coronary arteries. Despite their rarity, coronary artery anomalies represent a significant burden on cardiovascular health due to their potential to disrupt myocardial blood flow and precipitate adverse cardiac events. While historically diagnosed postmortem, the widespread availability of imaging modalities has led to an increased recognition of coronary artery anomalies, particularly in adults. This review synthesizes current knowledge on the classification, mechanisms, and clinical implications of coronary anomalies, focusing on prevalent variants with significant clinical impact. We discuss strategies for medical and surgical management, as well as contemporary screening recommendations, acknowledging the evolving understanding of these anomalies. Given the breadth of possible variants and the limited data on some presentations, this review provides a framework to aid clinicians in the recognition and management of coronary anomalies, with a particular emphasis on their stratification by anatomical location. By consolidating existing knowledge and highlighting areas of uncertainty, this review aims to enhance clinical decision-making and improve outcomes for individuals with coronary anomalies.

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Congenital atresia of the left main coronary artery: Imaging feature in children

Cited by 2 publications

References 9 publications

Clinical Characteristics of Congenital Atresia of the Left Main Coronary Artery in 12 Children

Clinical Characteristics of Congenital Atresia of the Left Main Coronary Artery in 12 Children

Coronary Artery Anomalies: Diagnosis & Management

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