Focus on Echocardiographic and <scp>D</scp>oppler Analysis of Coronary Artery Abnormal Origin from the Pulmonary Trunk with Mild Myocardial Dysfunction

Courand, Pierre‐Yves; Bozio, A; Ninet, J; Hénaine, Roland; Veyrier, Magali; Bakloul, Mohamed; Boussel, Loîc; Filippo, Sylvie Di

doi:10.1111/echo.12124

Cited by 18 publications

(17 citation statements)

References 16 publications

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“…Noninvasive cardiovascular imaging, namely transthoracic echocardiography and Doppler specific parameters, can reach diagnosis of late presentation of ALCAPA. 6 In our patient, transthoracic echocardiography revealed a prominent large ostium in the right coronary artery and multiple turbulent flow in the ventricular septum due to abundant intercoronary collaterals (so-called steal collaterals). Such echocardiographic findings should raise a high suspicion for this syndrome.…”

Section: Discussionmentioning

confidence: 59%

“…Late presentation of ALCAPA is characterized by abundant development of intercoronary collaterals resulting in mild and rare symptoms, which nevertheless can cause sudden cardiac death. Noninvasive cardiovascular imaging, namely transthoracic echocardiography and Doppler specific parameters, can reach diagnosis of late presentation of ALCAPA . In our patient, transthoracic echocardiography revealed a prominent large ostium in the right coronary artery and multiple turbulent flow in the ventricular septum due to abundant intercoronary collaterals (so‐called steal collaterals).…”

Section: Discussionmentioning

confidence: 65%

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Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in the Adult

2013

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect in adults. We report a 38-year-old male presenting with exertional syncope. He was referred for the evaluation of multiple muscular ventricular septal defects diagnosed on an outpatient echocardiogram. Echocardiography revealed mild left ventricular enlargement, abnormal flow-pattern in the ventricular septum and dilatation of the right coronary artery. Pulsed-wave Doppler with sample volume placed in the coronary ostium showed systolic coronary flow predominancy. This unique finding is characteristic for ALCAPA and can differentiate it from other coronary anomalies. Coronary angiography confirmed ALCAPA syndrome. Surgical correction was planned.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 65%

Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in the Adult

2013

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“…Transthoracic echocardiography also has diagnostic value on other congenital heart diseases, including sinus of valsalva aneurysm [ 27 ], coronary sinus septal defect [ 28 ], coronary artery fistula [ 29 ], left coronary artery arising from the right pulmonary artery [ 30 ] and so on excerpt aortic coarctation.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Transthoracic Echocardiography in Patients with Coarctation of Aorta: The Chinese Experience in 53 Patients Studied between 2008 and 2012 in One Major Medical Center

Sun

Cheng²,

Ling

et al. 2015

PLoS ONE

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Although aortography is well known as the “gold standard” for the diagnosis of coarctation of aorta (CoA), the method is invasive, expensive and not readily accepted by some patients. Ultrasound diagnosis for CoA is non-invasive, inexpensive, readily accepted by every patient, and can be repeated as frequently as necessary. The purpose of this presentation is to evaluate the applicability of transthoracic echocardiography for the diagnosis of CoA. The echocardiographic appearances of 53 patients with CoA who had undergone surgery during a 5-year period from January 2008 to October 2012 were analyzed retrospectively, and the results were compared with findings at surgery. Fifty-three patients with CoA include six with isolated CoA and 47 of CoA associated with other cardiac anomalies. Of the 53 operated patients, 48 were correctly diagnosed preoperatively by echocardiography, while two were misdiagnosed as interrupted aortic arch and the diagnosis were missed in three other patients. Thus the diagnostic accuracy rate was 90.6%, and the misdiagnosis rate was 9.4%. Preoperative echocardiographic evaluation offers very satisfactory anatomic assessment in most patients with CoA. It makes preoperative angiography unnecessary. Thus transthoracic echocardiography should be the first-line method for the diagnosis of coarctation of the aorta.

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“…All patients aged more than 40 years and, in contrast to this case, all had plentiful intercoronary collaterals and dilation of RCA. 12 Iriat et al showed that measurement of 2D strain is helpful in detection of subclinical ischemia in a 13-year-old patient with ALCAPA. Pulmonary artery pressure was not mentioned in their report.…”

Section: Speculations On Pathophysiology Of Ph In This Casementioning

confidence: 99%

“…Pulmonary artery pressure was not mentioned in their report. 12 Pathophysiologically, patients with ALCAPA either have the infantile type and die early because of poor intercoronary collateralization or have the adult type with adequate collateralization which enables them to survive beyond infancy 13 . This case, cannot be included in neither of these two former groups.…”

Section: Speculations On Pathophysiology Of Ph In This Casementioning

confidence: 99%

Anomalous origin of left coronary artery from pulmonary artery associated with pulmonary hypertension

Rad

2014

Indian Heart Journal

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This is a report on a 10-year-old child with anomalous origin of left coronary artery (LCA) from pulmonary artery (ALCAPA), severe pulmonary hypertension (PH), old myocardial infarction and poor intercoronary collateralization. It discusses the echocardiographic pitfalls in this particular setting and introduces a new echocardiographic view (posterior pulmonary cusp view) for visualization of the anomalous origin of LCA from the posterior pulmonary cusp (PC) in patients with ALCAPA from the PC of the pulmonary artery. We describe three echocardiographic pitfalls that can mislead the echocardiographer and two helpful hints that guide the clinician to the correct diagnosis. The survival of this child shows that limited size of left ventricular myocardial infarction and severe mitral regurgitation in early infancy can result in a life-saving pulmonary hypertension which preserves viability and function of left ventricle despite lack of intercoronary collateral arteries. After one year follow-up, she is doing well on medical treatment.

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Focus on Echocardiographic and Doppler Analysis of Coronary Artery Abnormal Origin from the Pulmonary Trunk with Mild Myocardial Dysfunction

Cited by 18 publications

References 16 publications

Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in the Adult

Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in the Adult

Diagnostic Value of Transthoracic Echocardiography in Patients with Coarctation of Aorta: The Chinese Experience in 53 Patients Studied between 2008 and 2012 in One Major Medical Center

Anomalous origin of left coronary artery from pulmonary artery associated with pulmonary hypertension

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