scholarly journals Newborn girl with coarctation of the aorta and anomalous left coronary artery from pulmonary artery, with retrograde perfusion of left circumflex artery: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-4
Author(s):  
Martin Hölscher ◽  
Walter Knirsch ◽  
Hitendu Dave ◽  
Barbara E U Burkhardt
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Aortic Coarctation ◽  
Left Coronary Artery ◽  
Aortopulmonary Window ◽  
Anomalous Left Coronary Artery ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Retrograde Perfusion ◽  
Anomalous Left Coronary

Abstract Background Anomalous left coronary artery from pulmonary artery (ALCAPA) is a rare coronary abnormality. Although it exists usually as an isolated abnormality, ALCAPA has been described with aortic pathologies like coarctation or aortopulmonary window. Case summary An 18-day-old female was admitted to the paediatric intensive care unit because of a heart murmur and weak femoral pulses. A transthoracic two-dimensional echocardiography was performed and confirmed suspected diagnosis of aortic coarctation. In addition, a total retrograde perfusion of the left circumflex coronary artery (LCX) was found, without visible flow through the ostium of the left coronary artery (LCA) into the aorta. A coronary angiography was performed, showing a single right coronary artery with a normal right posterior descending artery (RPD). Supplied by collaterals from the RPD, the LCX was perfused retrogradely, passing by the lateral wall of the ascending aorta without flowing into it, but into the right pulmonary artery. At 23 days of age, surgery was performed with resection of the aortic coarctation and reimplantation of the LCA into the posterior aortic wall. Discussion This case demonstrates that coronary artery anomalies like ALCAPA may occur together with other cardiac malformations. Despite concomitant cardiac lesions, careful assessment of the coronary arteries is mandatory, including cardiac catheterization in case of doubt.

Pre-operative identification of an anomalous left coronary artery from the pulmonary artery in association with tetralogy of Fallot and an aortopulmonary window

2013 ◽  
Vol 24 (1) ◽  
pp. 170-171 ◽  
Author(s):  
Colin J. McMahon ◽  
Terence Prendiville ◽  
Lars Nolke
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Left Coronary Artery ◽  
Surgical Intervention ◽  
Aortopulmonary Window ◽  
Anomalous Left Coronary Artery ◽  
Arterial Anomaly ◽  
Operative Assessment ◽  
Anomalous Left Coronary

AbstractA newborn baby girl was diagnosed with tetralogy of Fallot and an aortopulmonary window. At 3 weeks of age, the coexistent diagnosis of an anomalous left coronary artery from the pulmonary artery was made. Initial surgical intervention included a Takeuchi baffle of the left coronary artery, closure of the aortopulmonary window, and placement of a right Blalock–Taussig shunt. Complete repair was undertaken at 12 months of age. Close pre-operative assessment of the coronary arterial anomaly is crucial in patients with an aortopulmonary window and tetralogy of Fallot.

scholarly journals Severe baffle leak after Takeuchi repair successfully treated with coronary bypass and percutaneous baffle closure: a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Syed Yaseen Naqvi ◽  
Michael Joynt ◽  
Sunil Prasad ◽  
Frederick Ling
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Left Internal Mammary Artery ◽  
Late Complication ◽  
Coronary Bypass ◽  
Aortopulmonary Window ◽  
Anomalous Left Coronary Artery ◽  
Takeuchi Procedure ◽  
Anomalous Left Coronary

Abstract Background Anomalous left coronary artery from the pulmonary artery is a rare congenital abnormality that requires surgical correction. Case summary We describe the case of a 33-year-old female with a history of anomalous left coronary artery of the pulmonary artery who presents with exertional angina. She underwent a Takeuchi repair that was complicated by a baffle leak. She was successfully treated with left internal mammary artery-left anterior descending (LAD) bypass grafting and percutaneous baffle leak closure. Discussion The Takeuchi procedure involves the creation of an aortopulmonary window and an intrapulmonary tunnel that ‘baffles’ the aorta to the ostium of the anomalous left coronary artery. The most common late complication of the Takeuchi procedure is the presence of a baffle leak. Percutaneous baffle leak occlusion via vascular plug and coronary bypass of the LAD can successfully treat a baffle leak with excellent short-term follow-up.

Incidence and clinical relevance of primary congenital anomalies of the coronary arteries in children and adults

2012 ◽  
Vol 23 (3) ◽  
pp. 381-386 ◽  
Author(s):  
Giulia Tuo ◽  
Maurizio Marasini ◽  
Claudio Brunelli ◽  
Lucio Zannini ◽  
Manrico Balbi
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Paediatric Population ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Anomalous Left Coronary Artery ◽  
Left Circumflex Artery ◽  
Anomalous Left Coronary

AbstractObjectivesTo describe our experience in the management of coronary artery anomalies both in an adult and in a paediatric population and to compare the two groups for finding out differences in terms of angiographic incidence and treatment.Patients and methodsDatabases at the Department of Cardiology of San Martino Adult's Hospital and of Gaslini Children's Hospital were searched for all patients with a diagnosis of coronary artery anomaly who underwent coronary angiography between 1994 and 2006.ResultsCoronary anomalies were diagnosed in 76 (1%) adult patients. Anomalous left circumflex artery was the commonest coronary anomaly (25%). Anomalous left coronary artery from pulmonary artery and myocardial bridges were the only anomalies responsible for angina-like symptoms. No patients except the one with anomalous left coronary artery from pulmonary artery needed surgical intervention. In the paediatric population, we found 28 (0.9%) patients with coronary anomalies. Anomalous left coronary artery from pulmonary artery was the most common anomaly (48%) and always required emergency surgical treatment; in addition there were two patients with stenosis of the left main coronary artery.ConclusionCoronary artery anomalies may be associated with very acute, even life-threatening symptoms in children, whereas they are usually clinically silent and detected by accident on coronary angiography in adults. Recognition of coronary artery anomalies enables early treatment or close follow-up in children, whereas it could be useful in case of cardiac surgery in adults.

Intraoperative Diagnosis of ALCAPA Complicating an Aortopulmonary Window Repair

2021 ◽  
pp. 215013512097576
Author(s):  
Diego Márquez ◽  
Tomás Chalela ◽  
Nestor Sandoval
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Uneventful Recovery ◽  
Aortopulmonary Window ◽  
Anomalous Left Coronary Artery ◽  
Intraoperative Diagnosis ◽  
Anomalous Left Coronary

We present the case of transient left ventricular dysfunction secondary to impaired left coronary artery filling after aortopulmonary window repair, caused by intraoperative diagnosis of anomalous left coronary artery from pulmonary artery. Immediate recognition and repair allowed for uneventful recovery of the patient.

Repair of Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) beyond Infancy

2013 ◽  
Vol 16 (4) ◽  
pp. 210 ◽  
Author(s):  
Sachin Talwar ◽  
Aandrei Jivendra Jha ◽  
Shiv Kumar Choudhary ◽  
Saurabh Kumar Gupta ◽  
Balram Airan
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Respiratory Tract ◽  
Left Coronary Artery ◽  
Nyha Class ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Anomalous Left Coronary Artery ◽  
Tract Infections ◽  
Anomalous Left Coronary

Between January 2002 and December 2012, five patients (4 female) underwent corrective surgery for anomalous left coronary artery from pulmonary artery (ALCAPA). They were older than 1 year (range, 3-56 years). One of the 2 patients younger than 10 years had presented with congestive heart failure, and the other had experienced repeated episodes of lower respiratory tract infection since childhood. Of the remaining 3 adult patients, 2 had experienced angina with effort, and 1 patient had had repeated respiratory tract infections since childhood, with mild dyspnea on effort of New York Heart Association (NYHA) class II. Three patients had the anomalous left coronary artery implanted directly into the ascending aorta via coronary-button transfer, and 2 patients underwent coronary artery bypass with obliteration of the left main ostium. Two patients underwent concomitant mitral valve repair procedures, and 1 patient underwent direct closure of a perimembranous ventricular septal defect. Four patients survived the surgery, and 1 patient died because of a persistently low cardiac output. Follow-up times ranged from 3 months to 4 years. All survivors are in NYHA class I and have left ventricular ejection fractions of 45% to 60%, with moderate (n = 1), mild (n = 1), or no (n = 2) mitral insufficiency. We conclude that a few naturally selected patients with ALCAPA do survive beyond infancy and can undergo establishment of 2 coronary systems with satisfactory results.

scholarly journals Anomalous left coronary artery from the pulmonary artery: a rare cause of an out-of-hospital cardiac arrest in an adult—a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5
Author(s):  
Madelien V Regeer ◽  
Olga Bondarenko ◽  
Katja Zeppenfeld ◽  
Anastasia D Egorova
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Complication Rates ◽  
Anomalous Left Coronary Artery ◽  
Subcutaneous Icd ◽  
Hospital Cardiac Arrest ◽  
Anomalous Left Coronary

Abstract Background Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital disorder resulting in ischaemia and myocardial infarction which can act as a potential substrate for life-threatening arrhythmias and sudden cardiac death. Case summary A 19-year-old man was admitted to the hospital after successful resuscitation from an out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation occurring during jogging. In the diagnostic work-up of the OHCA, computed tomography identified an ALCAPA. The patient was referred to our tertiary hospital for surgical correction. Direct reimplantation of the left coronary artery in the aorta was performed. During follow-up, 24-h electrocardiogram revealed short episodes of non-sustained ventricular tachycardia (VT). The magnetic resonance imaging at initial admission showed focal wall thinning and transmural late gadolinium enhancement consistent with a previous anterolateral myocardial infarction. Therefore, the aetiology of the OHCA could be due to a scar-related mechanism and not necessarily due to a reversible cause and an implantable cardioverter-defibrillator (ICD) was considered indicated. Given the young age and the lower complication rates, a subcutaneous device was preferred over a transvenous ICD. However, as a subcutaneous ICD (S-ICD) lacks the possibility of anti-tachycardia pacing, programmed electrical stimulation (PES) was performed to test for inducibility of monomorphic, re-entrant VT. After a negative PES, an S-ICD was implanted. Discussion ALCAPA is a potential cause of OHCA in young patients. Some of these patients keep an irreversible substrate for ventricular arrhythmias despite full surgical revascularization and might be candidates for (subcutaneous) ICD implantation.

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