Anomalous Origin of the Circumflex or Left Anterior Descending Artery From the Pulmonary Artery

Guenther, Timothy M.; Sherazee, Elan A.; Gustafson, Joshua D.; Wozniak, Curtis J.; Raff, Gary W.

doi:10.1177/2150135120938705

Cited by 7 publications

(23 citation statements)

References 44 publications

(43 reference statements)

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“…In patients without structural heart disease the occurrence of coronary anomalies is between 0.3-0.9%, with a signi cantly higher occurrence of 3-36% in patients with structural heart defects [1]. While the majority of aberrant origin of a coronary artery coronary artery origin are benign, there are subtypes that entail a risk of myocardial ischemia [2]. When no congenital heart disease is present, the presence of an anomalous LCX arising from the pulmonary artery is subsequently very rare [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…The precise incidence of anomalous coronary origin from the pulmonary artery is unknown. In literature, the distribution in patients with anomalous coronary arteries is 85.7% Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA), 6.1% Anomalous Circum ex Artery from the Pulmonary Artery (ACxAPA), 4.1% Anomalous Right Coronary Artery from the Pulmonary Artery (ARCAPA) and 2.0% Anomalous Left Anterior Descending Artery from the Pulmonary Artery (ALADAPA) [2]. In ACxAPA, the majority arises from the right pulmonary artery.…”

Section: Discussionmentioning

confidence: 99%

“…In ACxAPA, the majority arises from the right pulmonary artery. In approximately 40% of the ACxAPA and ALADAPA patients, a concomitant cardiac lesion was found [2][3].…”

Section: Discussionmentioning

confidence: 99%

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Anomalous origin of the circumflex coronary artery from the pulmonary artery: a case report

Donné

Vandekerckhove

Drieghe

et al. 2023

Preprint

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Case description: A 4-year old boy without significant prior history, presented with pronounced dyspnea. During clinical examination only mild hepatomegaly was present. Thoracic radiography showed significant cardiomegaly. Echocardiography revealed left ventricular dilatation and poor systolic function. Both Troponin and NT-pro-BNP level were elevated. Treatment with diuretics and inotropics was started with clinical improvement. The diagnosis of an anomalous left circumflex artery out of the right pulmonary artery was suspected by coronarography and confirmed by coronary CT. Coronary reimplantation was performed without complications. Subsequently, left ventricular dimensions normalized progressively in the next months. Discussion: Without congenital heart disease, an anomalous left circumflex artery arising from the pulmonary artery is rarely present. Symptoms and prognosis are determined by the amount of collateral circulation to provide adequate myocardial perfusion. Diagnosis of an anomalous left circumflex artery (LCx) is mostly made at adult age. However, our patient presented at young age. Even though the origin of both coronary arteries was normal, a coronary anomaly lies at the origin of his cardiac dysfunction. Treatment consisting of surgical reimplantation or coronary bypass is the primary choice. Conclusion: We present this case to highlight the importance of having a high index of suspicion of coronary artery abnormalities in children with dilated cardiomyopathy, as the prognosis can be very favorable after surgical repair. Transthoracic echocardiography is not always conclusive in showing a normal origin of both coronary arteries and certainly not for visualizing the LCx reliably. Therefore, further imaging should be considered in children with a new diagnosis of unexplained DCM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anomalous origin of the circumflex coronary artery from the pulmonary artery: a case report

Donné

Vandekerckhove

Drieghe

et al. 2023

Preprint

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“…In contrast, ARCAPA is a rare condition with an incidence rate of approximately 0.002% and in contrast with ALCAPA, most patients have no obvious clinical symptoms at the early stage, and the condition is typically diagnosed in combination with other cardiovascular diseases ( 6 ). The coronary LAD or LCX originating from the pulmonary artery is very rare and its incidence remains unknown ( 3 ); at present, 97 such cases have been identified worldwide ( 7 ) and, compared with ALCAPA, the symptoms of this type are not typically obvious in infancy.…”

Section: Classification and The Hemodynamics Of Anomalous Origin Of T...mentioning

confidence: 99%

“…Cases in which the LAD or LCX branches originate from the pulmonary artery are extremely rare; in these cases, the onset among patients is approximately 25 years of age ( 7 ), and the clinical symptoms are very similar to myocardial ischemia (angina pectoris, shortness of breath, and palpitation); a small number of patients may be asymptomatic. In more than half of patients with anomalous origin of the LAD branch from the pulmonary artery, murmurs could be heard in the mitral auscultation and systolic areas, and the patient’s cardiac function was typically significantly improved after surgical intervention ( 7 ).…”

Section: Clinical Symptoms In Cases Of Anomalous Origin Of the Corona...mentioning

confidence: 99%

Imaging options for defining anomalous origin of the coronary artery from the pulmonary artery

Xin¹,

Zhu²

2023

Quant Imaging Med Surg

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Anomalous origin of the coronary artery from the pulmonary artery is a rare type of congenital heart disease (CHD). According to the establishment of collateral circulation and the abnormal anatomy of coronary arteries, there are several clinical types. In some clinical types, serious cardiac insufficiency can arise in the early stage of the condition, which, if not promptly treated, can endanger the patient's life. Up to 90% of infants with an anomaly involving the left coronary artery die within the first year of life. The treatment of the disease is to restore the double coronary circulation as soon as possible by surgery after early detection by diagnostic imaging. Presently, medical imaging is the most commonly used examination method for a diagnosis of the disease. The comprehensive application of various imaging modalities is the basis for the diagnosis and follow-up of coronary artery origin from the pulmonary artery. The current review mainly summarized the common signs and application advantages of different imaging techniques in the diagnosis of anomalous origin of the coronary artery from the pulmonary artery. It also highlights existing problems and provides an important theoretical basis and practical guidance for imaging techniques about the coronary artery originating from the pulmonary artery's diagnosis and treatment.

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Coronary artery anomalies

Newburger,

Beroukhim,

Quinonez

2025

Nadas' Pediatric Cardiology

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Anomalous Origin of the Circumflex or Left Anterior Descending Artery From the Pulmonary Artery

Cited by 7 publications

References 44 publications

Anomalous origin of the circumflex coronary artery from the pulmonary artery: a case report

Anomalous origin of the circumflex coronary artery from the pulmonary artery: a case report

Imaging options for defining anomalous origin of the coronary artery from the pulmonary artery

Coronary artery anomalies

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