A hidden culprit for ventricular dysfunction in aortopulmonary window repair: Anomalous origin of left coronary artery. Case report and review of literature

Alhadlaq, Adnan; Dhillon, Santokh; Hancock-Friesen, Camille; Hussain, Arif

doi:10.1016/j.jtcvs.2016.07.055

Cited by 9 publications

(12 citation statements)

References 16 publications

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“…Association of AP Window with ALCAPA is extremely rare, and to date, we found 11 published articles with this association, all case reports, and none with preoperative diagnosis. 7,8 Multiple reports of the association of APW and coronary arteries anomalies are published, but most of them are with an anomalous RCA. In our case, the ALCAPA was diagnosed intraoperatively after removing aortic cross-clamp without reperfusion of the LV, allowing immediate correction of the defect and an adequate recovery for the patient.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Diagnosis of ALCAPA Complicating an Aortopulmonary Window Repair

Márquez

Chalela

Sandoval

2021

World J Pediatr Congenit Heart Surg

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Section: Discussionmentioning

confidence: 99%

Intraoperative Diagnosis of ALCAPA Complicating an Aortopulmonary Window Repair

Márquez

Chalela

Sandoval

2021

World J Pediatr Congenit Heart Surg

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“…Failure to identify and correct this coronary anomaly during surgery for associated lesions would result in unforeseen postoperative ventricular dysfunction. 3,4…”

Section: Discussionmentioning

confidence: 99%

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

Arvind

Devagourou

Saxena

2021

World J Pediatr Congenit Heart Surg

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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.

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“…We found only one patient with associated congenital heart disease in our series, who had APW. Occurrence of ALCAPA in a patient with APW is extremely rare with only a few cases described in the literature 19,20 . In almost all of these cases, ALCAPA was diagnosed intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Occurrence of ALCAPA in a patient with APW is extremely rare with only a few cases described in the literature. 19,20 In almost all of these cases, ALCAPA was diagnosed intraoperatively. Identification of ALCAPA in a patient with APW in our series also highlights the crucial role of preoperative CT angiography to avoid intraoperative adverse events.…”

Section: Discussionmentioning

confidence: 99%

Anomalous origin of left main coronary artery from pulmonary artery: Patient characteristics and imaging associations on multidetector computed tomography angiography

Ojha

Pandey

Kumar

et al. 2021

Journal of Cardiac Surgery

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Aim To evaluate the various imaging features and associations on multidetector computed tomography (CT) angiography in patients with anomalous origin of left main coronary artery (LMCA) from pulmonary artery (ALCAPA). Materials and Methods We retrospectively reviewed multidetector CT angiography studies done for the evaluation of congenital heart diseases at our institution through 2014 to 2021. Cases with ALCAPA were identified and relevant history and imaging findings including the origin of coronary arteries, left ventricular (LV) morphology and functions, intercoronary collaterals, and associated abnormalities were evaluated. Results Twelve patients (eight males, three adults, and nine children; age range: 2 months to 54 years) with ALCAPA were included. Gradually progressive dyspnea and failure to thrive (6/9; 66.67% each) were the most common symptoms among children, whereas adults were commonly asymptomatic (2/3; 66.67%). The LMCA was originating from pulmonary sinus, main, and right pulmonary artery in 6 (50%), 5 (41.66%), and 1 (8.3%) patients, respectively. In adult‐type ALCAPA, right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCx) were dilated and tortuous, with the presence of well‐developed intercoronary collaterals and preserved LV ejection fractions; these features were not seen in patients of infantile ALCAPA. LV dysfunction with global hypokinesia was the most common wall motion abnormality (7/12; 58.33%). Conclusion Degree of collateralization could be the key factor determining the time of presentation, clinical symptoms, and LV function, thus influencing clinical outcomes. Patients with infantile ALCAPA present with features of heart failure and have dilated and dysfunctional LV consequent to lack of collaterals, unlike adult‐type ALCAPA.

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A hidden culprit for ventricular dysfunction in aortopulmonary window repair: Anomalous origin of left coronary artery. Case report and review of literature

Cited by 9 publications

References 16 publications

Intraoperative Diagnosis of ALCAPA Complicating an Aortopulmonary Window Repair

Intraoperative Diagnosis of ALCAPA Complicating an Aortopulmonary Window Repair

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

Anomalous origin of left main coronary artery from pulmonary artery: Patient characteristics and imaging associations on multidetector computed tomography angiography

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