The Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Keith, John D.

doi:10.1136/hrt.21.2.149

Cited by 269 publications

(137 citation statements)

References 9 publications

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“…Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital cardiovascular defect that occurs in approximately 1/300,000 live births or 0.5% of children with congenital heart diseases [1]. This anomaly causes coronary blood steal to pulmonary artery leading to myocardial ischemia and if left untreated can lead to dilated cardiomyopathy and death.…”

Section: Introductionmentioning

confidence: 99%

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Dilawar¹,

Ahmad²

2012

OJPed

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Anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. In this study, we present all the ALCAPA patients which were admitted at our institution during April 2007-December 2010. Retrospective review of these patients regarding their clinical presentation and the use of diagnostic modalities will be presented in this series. There were total of five patients, three male and 2 female, with age range of 2 -12 months. The most common symptoms at presentation were tachypnea (4/5) and poor feeding with irritability (3/5). Electrocardiogram was abnormal in 2/5 cases and chest X ray revealed cardiomegaly with pulmonary congestion in 4/5 patients. Echocardiogram showed mitral valve regurgitation in 5/5 cases (3 with moderate and 2 with mild to moderate), Left ventricular dilatation/dysfunction in 4/5 patients, echogenic left ventricular papillary muscles in 4/5 patients and prominent right coronary with strong suspecision of ALCAPA in 4/5 patients. Coronary angiography was performed in 4/5 cases to confirm the diagnosis. We conclude that by thorough clinical assessment along with ECG and CXR, the diagnosis of ALCAPA can be strongly suspected. Echocardiogram can almost always make the diagnosis of ALCAPA and coronary angiography can confirm the diagnosis in rare atypical cases.

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Section: Introductionmentioning

confidence: 99%

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Dilawar¹,

Ahmad²

2012

OJPed

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“…7 Normally, the left coronary artery arises from the left coronary sinus in the aorta, courses under the left auricle, then branches into the descending (paraconal) and circumflex branches. The left coronary artery provides two thirds of the cardiac blood supply, including that of the entire left atrium and ventricle.…”

Section: Introductionmentioning

confidence: 99%

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in Four Calves

et al. 2008

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Abstract. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), or Bland-White-Garland syndrome, is a rare congenital malformation described in children and adults. In this condition, the left coronary artery, which normally originates from the left coronary sinus in the aorta, instead originates from the pulmonary trunk, which results in retrograde flow of blood away from the myocardium into the lower-pressure pulmonary artery. Myocardial hypoxic-ischemic injury results in cardiac dysfunction, failure, and eventually in patient death if not surgically repaired. This report describes gross and microscopic findings in 4 beef calves with ALCAPA. All the calves had a history of being found dead with few or no premonitory signs, 2 shortly after sudden strenuous exercise. Gross necropsy lesions suggestive of heart failure included cardiomegaly with atrial and ventricular dilation and/or ventricular hypertrophy, and hepatomegaly. Dissection of each heart revealed the origin of the left coronary artery arising in the pulmonary trunk above the anterior cusp of the pulmonic valve. No other cardiac anomalies were identified. Histopathologic changes in the heart included cardiomyocyte degeneration; mineralization; and fiber loss, with replacement by fibrous connective tissue, predominantly in the left ventricular papillary muscle and the interventricular septum. Changes observed in the liver and lungs, including hepatomegaly, sinusoidal congestion, centrilobular fibrosis, and pulmonary congestion, edema, and intra-alveolar pigment-laden macrophages were consistent with heart failure.

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“…Anomalous origin of left coronary artery from pulmonary artery is a rare congenital cardiovascular malformation, which occurs in approximately 1 in 300,000 live births or 0.25% to 0.5% of children with congenital heart disease. 5 The incidence of abnormal aortic origin of coronary arteries is low with reported values of 0.64% of births. 6 and 0.17% in asymptomatic children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

Anomalous Origin of Coronary Arteries: Anatomical Study and Clinical Correlates

Jayasree¹,

Ashalatha²

2016

jemds

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AIMS AND OBJECTIVESThe arterial supply of the heart is obtained by the two coronary arteries, right and left, which originate respectively from the right and left aortic sinuses of ascending aorta. Considering all congenital cardiac anomalies, the anomalous origin of coronary arteries is relatively rare, but clinically much significant when present. Anomalous coronary arteries and their clinical relevance have been reported by various workers as cases identified in cardiac patients, in cadaveric hearts and in autopsy findings. The present study aims to identify the prevalence of anomalous origin of coronary arteries and correlate them with possible clinical manifestations. STUDY SETTINGS AND DESIGNA cadaveric study was conducted in human hearts in the Department of Anatomy, Govt. Medical College, Kozhikode, Kerala. MATERIALS AND METHODSThe study was done in 60 hearts, 30 from adult cadavers and 30 from stillborn full-term foetuses. In each heart the origin of both coronary arteries were carefully studied, looking particularly for anomalies if any. The observations were recorded and photographed. RESULTS AND ANALYSISIn the present study in two hearts, both foetal coronary arteries had anomalous origin. In both the origin of right coronary artery was anomalous, one originating from left aortic sinus and the other from pulmonary trunk. In the former case, the left coronary artery had origin from pulmonary trunk. The incidence of anomalous origin of right coronary artery was 3.3% and that of left coronary artery was 1.7%. CONCLUSIONThough many patients with similar anomalies of coronary arteries may remain asymptomatic, reports from clinical studies indicate that some of them present with serious complications like attacks of syncope, pulmonary coronary steal, myocardial ischaemia and sudden cardiac death. Such cases pose diagnostic challenge to paediatricians, physicians, cardiologists and cardiothoracic surgeons. The awareness of the possibility of anomalous coronary arteries is essential for its proper recognition and diagnosis in early stages of life, which will enable timely surgical intervention and better prognosis. In this background, we discuss the clinical significance of anomalous origin of coronary arteries with review of relevant literature.

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The Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Cited by 269 publications

References 9 publications

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in Four Calves

Anomalous Origin of Coronary Arteries: Anatomical Study and Clinical Correlates

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