Unique Association of Aortopulmonary Window With Anomalous Origin of Left Coronary Artery From Pulmonary Artery in an Infant: A Blessing in Disguise?

2021 ◽  
pp. 215013512110600
Author(s):  
Balaji Arvind ◽  
Velayoudam Devagourou ◽  
Anita Saxena
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Ventricular Dysfunction ◽  
Anomalous Origin ◽  
Aortopulmonary Window ◽  
Coronary Anomaly ◽  
Computed Tomography Angiogram ◽  
Unique Association ◽  
Do So

Aortopulmonary window (APW) seen in association with anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is extremely uncommon. When faced with this combination, ALCAPA usually goes undetected since most of the clinical and echocardiographic features of ALCAPA, including ventricular dysfunction are absent due to co-existent pulmonary hypertension. Herein we report a 5-month-old child with a large APW in whom a preoperative computed tomography angiogram facilitated the diagnosis of ALCAPA. The case is described for its rarity and the challenges faced during management. Also, it is extremely crucial that this coronary anomaly is identified and corrected during surgery, since failure to do so results in unforeseen postoperative ventricular dysfunction.

scholarly journals Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery As a Rare Cause of Left Ventricular Dysfunction

2019 ◽  
Vol 12 (12) ◽  
Author(s):  
Ligia Lopes Balsalobre Trevizan ◽  
Amit Nussbacher ◽  
Maria Carolina Bueno da Silva ◽  
Walther Yoshiharu Ishikawa ◽  
Sergio Almeida de Oliveira ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Ventricular Dysfunction ◽  
Left Coronary Artery ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Anomalous Origin

scholarly journals ALADPA : Snake in the Heart

2015 ◽  
Vol 12 (1) ◽  
pp. 27-30
Author(s):  
Suresh Madhavan ◽  
Gargi Sathish ◽  
N Jayaprasad
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Structural Heart Disease ◽  
Anomalous Origin ◽  
Coronary Anomaly

Anomalous origin of left coronary artery from pulmonary artery may or may not be associated with structural heart disease. Most of the patients with such coronary anomaly will succumb unless diagnosed and treated early. We are reporting a patient with this anomaly in seventh decade which is extremely rare. DOI: http://dx.doi.org/10.3126/njh.v12i1.12341 Nepalese Heart Journal Vol.12(1) 2015: 27-30

One train may hide another: anomalous origin of the left coronary artery from the pulmonary artery revealed by supraventricular tachycardia

2011 ◽  
Vol 22 (1) ◽  
pp. 100-102
Author(s):  
Thomas Cognet ◽  
Pierre-Emmanuel Séguéla ◽  
Philippe Acar
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Supraventricular Tachycardia ◽  
Left Coronary Artery ◽  
Anomalous Origin ◽  
Coronary Anomaly ◽  
Unusual Association ◽  
Appropriate Care

AbstractWe report the case of a 1-month-old boy with an unusual association of supraventricular tachycardia and anomalous origin of the left coronary artery from the pulmonary artery. Although signs of infarction were visible on the first electrocardiogram, the presence of an arrhythmia did not immediately suggest a coronary anomaly. Echocardiography allowed the diagnosis, thus leading to appropriate care.

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.

Surgery and critical care for anomalous coronary artery from the pulmonary artery

2010 ◽  
Vol 20 (S3) ◽  
pp. 35-43 ◽  
Author(s):  
Timothy A. Fehrenbacher ◽  
Michael E. Mitchell ◽  
Nancy S. Ghanayem ◽  
James S. Tweddell
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Arterial System ◽  
Anomalous Origin ◽  
Anomalous Coronary Artery ◽  
Young Infants ◽  
Anomalous Coronary

AbstractAnomalous origin of the left coronary artery from the pulmonary artery is a rare congenital cardiac malformation that accounts for 0.25–0.50% of children with congenital cardiac disease and can cause myocardial dysfunction in young infants. In any infant presenting with ventricular dysfunction, the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery must be suspected and the origin of the coronary arteries must be confirmed. The diagnosis of anomalous origin of the left coronary artery from the pulmonary artery is an indication for surgical repair. A two-coronary arterial system is the goal and is almost always achievable. The goal of surgical therapy is the creation of a two-coronary arterial system, which appears to provide better long-term survival and protection from left ventricular dysfunction and mitral valvar regurgitation than does simple ligation of the anomalous coronary artery. Direct reimplantation of the anomalous coronary artery is the procedure of choice. It is straightforward and borrows from well-practised techniques commonly used in other procedures such as the arterial switch operation. For the rare patient in whom direct reimplantation is not possible, strategies to lengthen the anomalous coronary artery, or baffle it within the pulmonary root, are available. Mitral valvar regurgitation is common at presentation, but following the establishment of a two-coronary arterial system and satisfactory myocardial perfusion, regurgitation of the mitral valve resolves in the vast majority. Therefore, mitral valvuloplasty at the time of initial surgery for anomalous origin of the left coronary artery from the pulmonary artery is not indicated. Post-operative care requires careful manipulation of inotropic support and reduction of afterload. Mechanical support, with either extracorporeal membrane oxygenation or left ventricular assist device, should be available for use if necessary.

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