Anomalous origin of the left coronary artery from the pulmonary artery in a patient of advanced age: a case report and analysis

Abstract

A 61-year-old Chinese man presented with a nearly 30-year history of an anomalous origin of the left coronary artery. He had been diagnosed with an anomalous origin of the left coronary artery in 1989. He then underwent regular echocardiographic examinations and it was found that his heart was gradually enlarging. After a >20-year asymptomatic period, he developed recurrent chest discomfort and palpitation. Coronary computed tomography angiography suggested that the left coronary artery anomaly originated from the pulmonary artery; additionally, the right coronary artery was tortuous and thickened. Coronary angiography showed that the right coronary artery was huge and buckling. The patient underwent corrective surgery of the anomalous origin of the left coronary artery from the pulmonary artery, aortic valve mechanical valve replacement, mitral valve plasty, and tricuspid valve plasty in Fuwai Hospital (National Center of Cardiovascular Disease of China), and the anatomic results of the surgery were good.

Life saved and a lesson learned-anomalous origin of the left coronary artery from pulmonary artery in pregnancy

“…4 Two primary mechanisms of survival into adulthood have been described; well-formed inter-coronary collaterals perfusing the left ventricular myocardium or presence of high pulmonary artery pressures allowing antegrade flow into the left coronary artery. 5,6 Clinical presentation in adulthood typically entails angina, myocardial infarction, exertional dyspnoea, or sudden cardiac death. 6,7 The latter could be the first presentation accounting for 90% of cases presenting beyond infancy.…”

“…5,6 Clinical presentation in adulthood typically entails angina, myocardial infarction, exertional dyspnoea, or sudden cardiac death. 6,7 The latter could be the first presentation accounting for 90% of cases presenting beyond infancy. 2,3 Our patient presented 2 months peri-partum with witnessed aborted cardiac arrest, leading to timely diagnosis.…”