Left main coronary artery atresia with concomitant mitral regurgitation in an adult

Tian, Meice; Wang, Xinqiang; Gao, Huawei; Wang, Liqing; Hu, Shengshou

doi:10.1097/md.0000000000012367

Cited by 8 publications

(10 citation statements)

References 20 publications

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“…Furthermore, this may explain why the current patient survived without symptoms until the age of 40 years. Similarly, there are reports of adults diagnosed with LMCA in their 40s or later [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 91%

An Adult Case of Heart Failure due to Left Main Coronary Artery Atresia

et al. 2021

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Left main coronary artery (LMCA) atresia is a rare congenital heart disease and can be fatal in pediatric patients. We report an adult case of LMCA atresia, in which heart failure developed without episodes suggesting angina. A 40-year-old man presented with difficulty breathing. Echocardiography revealed diffuse hypokinesis of the left ventricle with an ejection fraction of 22% in the absence of significant valvular disease. A diagnosis of heart failure was made, and diuretics, enalapril, bisoprolol and warfarin were administered. Coronary angiography demonstrated no trace of the ostium of the LMCA in the sinuses of Valsalva; the middle to distal part of the LMCA was visualized by rich collateral flow from the right coronary artery to the left anterior descending coronary artery and left circumflex coronary artery. No trace of the ostium of the LMCA from the aorta or main pulmonary artery was detected on computed tomography angiography or echocardiography. The patient underwent coronary artery bypass grafting and a final diagnosis of congenital atresia of LMCA was made. The clinical course was uneventful and computed tomography angiography, performed 5 days after surgery, showed a patent bypass graft. This case demonstrates the importance of considering LMCA atresia even in the absence of chest symptoms suggesting angina in patients with heart failure.

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Section: Discussionmentioning

confidence: 91%

An Adult Case of Heart Failure due to Left Main Coronary Artery Atresia

et al. 2021

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“…Infants mostly present with failure to thrive and myocardial infarction, while children and adolescents may present with syncope and rhythm disturbances. Adult patients may present with dyspnea, angina, or sudden death [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Left Main Coronary Atresia with Significant Mitral Regurgitation in a 1-Year-Old Child

et al. 2021

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Congenital atresia of the left main coronary artery (LMCA) is an extremely rare coronary anomaly that necessitates surgical correction. Patients with LMCA atresia may have various clinical symptoms, which are determined by the degree of collateral vessel development from the right coronary system, the metabolic demands of the heart, and concomitant mitral insufficiency caused by myocardial ischemia. Unlike in adults, there are limited surgical options for coronary artery disease in children. Herein, we report a case of LMCA atresia with mitral regurgitation in a 19-month-old child that was successfully corrected by coronary artery bypass grafting and mitral valve repair.

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“…Adult patients usually present with angina pectoris at an advanced age when collateral flow cannot keep pace with myocardial demands. Children and adolescents often present with chest pain, dyspnea, syncope and tachyarrhythmia, and sudden cardiac death [2,3]. Infants mostly present with growth retardation and myocardial infarction [2].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of coronary artery anomalies has been reported to be 0.6-1.3%. [1] Left main coronary artery atresia (LMCAA) is the rarest form of congenital coronary malformations, in which coronary ostium and main trunk in the left coronary artery system is absent [2]. Thus, blood flows from the right coronary artery to the left coronary artery through collateral vessels [3].…”

Section: Introductionmentioning

confidence: 99%