scholarly journals Malignant Course of Anomalous Left Coronary Artery Causing Sudden Cardiac Arrest: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mahesh Anantha Narayanan ◽  
Christopher DeZorzi ◽  
Abhilash Akinapelli ◽  
Toufik Mahfood Haddad ◽  
Aiman Smer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Coronary Artery ◽  
Left Coronary Artery ◽  
Bypass Graft ◽  
Sudden Cardiac Arrest ◽  
Anomalous Coronary Artery ◽  
Anomalous Left Coronary Artery ◽  
Artery Disease ◽  
Anomalous Coronary ◽  
Anomalous Left Coronary

Sudden cardiac arrest has been reported to occur in patients with congenital anomalous coronary artery disease. About 80% of the anomalies are benign and incidental findings at the time of catheterization. We present a case of sudden cardiac arrest caused by anomalous left anterior descending artery. 61-year-old African American female was brought to the emergency department after sudden cardiac arrest. Initial EKG showed sinus rhythm with RBBB and LAFB with nonspecific ST-T wave changes. Coronary angiogram revealed no atherosclerotic disease. The left coronary artery was found to originate from the right coronary cusp. Cardiac CAT scan revealed similar findings with interarterial and intramural course. Patient received one-vessel arterial bypass graft to her anomalous coronary vessel along with a defibrillator for secondary prevention. Sudden cardiac arrest secondary to congenital anomalous coronary artery disease is characterized by insufficient coronary flow by the anomalous left coronary artery to meet elevated left ventricular (LV) myocardial demand. High risk defects include those involved with the proximal coronary artery or coursing of the anomalous artery between the aorta and pulmonary trunk. Per guidelines, our patient received one vessel bypass graft to her anomalous vessel. It is important for clinicians to recognize such presentations of anomalous coronary artery.

Anomalous Origin of the Left Coronary Artery

1996 ◽  
Vol 4 (3) ◽  
pp. 184-185
Author(s):  
Raju Subramaniam Iyer ◽  
Nguyen Khanh Huu ◽  
Marc de Levol
Keyword(s):  
Coronary Artery ◽  
Mitral Valve ◽  
Left Coronary Artery ◽  
Main Pulmonary Artery ◽  
Mitral Insufficiency ◽  
Anomalous Coronary Artery ◽  
Valve Repair ◽  
Anomalous Left Coronary Artery ◽  
Anomalous Coronary ◽  
Anomalous Left Coronary

A 4-month-old infant with an anomalous left coronary artery underwent a surgical correction in the form of tubular reconstruction of the anomalous coronary artery using a cuff of the main pulmonary artery and creation of a viable two-coronary artery system. Subsequently, mitral valve repair was performed for severe mitral insufficiency, which had not abated after the repair of the anomalous coronary artery. This case demonstrates the difficulties in diagnosing such patients, along with the advantage of creating a viable two-coronary artery system in such sick infants.

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.

scholarly journals Cardiac Arrest Associated with Both an Anomalous Left Coronary Artery and KCNE1 Polymorphism

2019 ◽  
Vol 60 (4) ◽  
pp. 1003-1005
Author(s):  
Hideki Kawai ◽  
Eiichi Watanabe ◽  
Seiko Ohno ◽  
Minoru Horie ◽  
Yukio Ozaki
Keyword(s):  
Cardiac Arrest ◽  
Coronary Artery ◽  
Left Coronary Artery ◽  
Anomalous Left Coronary Artery ◽  
Anomalous Left Coronary

scholarly journals Anomalous Left Coronary Artery Connected to the Pulmonary Artery in a 15-Year-Old Girl: Case Report and Discussion on Secondary Prevention of Sudden Death

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jérémy Laïk ◽  
Virginie Fouilloux ◽  
Philippe Aldebert ◽  
Linda Koutbi ◽  
Jérôme Hourdain ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Case Report ◽  
Coronary Artery ◽  
Sudden Death ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Anomalous Left Coronary Artery ◽  
Cardioverter Defibrillator ◽  
Anomalous Left Coronary

Background. Anomalous left coronary artery connected to the pulmonary artery (ALCAPA) is a rare congenital heart disease. Adaptive development of sufficient heterocoronary collaterality in the newborn may allow survival to a later age. In older children or adults, malignant ventricular arrhythmias can reveal the disease. Case Report. A 15-year-old girl was referred to the local hospital after a resuscitated out-of-hospital cardiac arrest. CT scan and coronary angiography revealed an ALCAPA. Direct aortic reimplantation of the left coronary artery was performed. Postoperative ECG monitoring showed short episodes of nonsustained ventricular tachycardia. Transthoracic echocardiography and cardiac MRI revealed subendocardial fibrosis of the anterolateral papillary muscle. Beta-blockade therapy was initiated at first intention. After hospital discharge, the patient reported several fainting without loss of consciousness. Considering sudden death nonrelated to effort, episodes of nonsustained ventricular tachycardia, and areas of myocardial fibrosis, the patient underwent subcutaneous cardioverter-defibrillator implantation. 6-month follow-up is satisfactory without clinical or rhythmic abnormalities. Discussion. Indication for surgical correction of ALCAPA is well defined, but rhythmic secondary prevention after resuscitated cardiac arrest is less consensual. Cardiac MRI is an essential tool in the identification of a potential rhythmic substrate and should be taken into account in the discussion of a preventive cardioverter-defibrillator implantation.

Myocardial infarction in infancy caused by compression of an anomalous left coronary artery arising from the right coronary artery

2004 ◽  
Vol 14 (6) ◽  
pp. 654-657 ◽  
Author(s):  
Christopher Duke ◽  
Eric Rosenthal ◽  
John M. Simpson
Keyword(s):  
Coronary Artery ◽  
Myocardial Ischaemia ◽  
Left Coronary Artery ◽  
Internal Thoracic Artery ◽  
Bypass Graft ◽  
Single Coronary Artery ◽  
Anomalous Left Coronary Artery ◽  
Left And Right ◽  
The Right ◽  
Anomalous Left Coronary

A 5-week-old child presented with a cardiac arrest secondary to myocardial ischaemia. Echocardiography demonstrated a single coronary artery arising from the right sinus of Valsalva. The coronary artery branched into left and right arteries, with the left artery then coursing anomalously in the tissue plane between the aortic root and the subpulmonary infundibulum. Compression of the left coronary artery caused severe myocardial ischaemia that resolved following construction of a bypass graft using the left internal thoracic artery. Stenosis at the anastomosis between the graft and the coronary artery was successfully treated by coronary angioplasty 2 years later.

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