Anomalous origin of the left coronary artery from the right pulmonary artery: Report of a case

Abstract

A 1-year-old boy was referred to our hospital for further investigation of mitral regurgitation. Color-Doppler echocardiography revealed the site of the anomalous origin of the left coronary artery which was confirmed by a cineangiographic study. This case is interesting for several reasons: the first is that the anomalous left coronary artery originated from the right pulmonary artery; the second is that two-dimensional echocardiographic findings can be misleading, i.e., a vessel-like structure which seemed to be the left coronary artery arising normally from the aorta was visualized; and the last is that a two-dimensional color-Doppler echocardiogram was useful in the diagnosis of the anomalous origin of the left coronary artery. The patient underwent implantation of the anomalous left coronary artery as well as Kay's plasty of the mitral valve, and has been doing well since then.

Anomalous origin of the left coronary artery from the right pulmonary artery with intramural aortic trajectory. Clinicosurgical diagnostic implications

“…AOLCAPA is rarely associated with other cardiac defects, except when the origin is the RPA, a very rare anatomical situation. Of the 20 cases of AOLCARPA reported in the literature [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (table I), 14 had associated defects [3][4][5][8][9][10]13,14,16,[18][19][20][21] , half of which were coarctation of the aorta 5,8,10,13,20 . Interventricular septal defect 4,14 and tetralogy of Fallot 3,21 were also observed.…”

“…AOLCAPA is rarely associated with other congenital defects, unless the right pulmonary artery (RPA) takes part in the anomaly. The presence of associated defects in 70% of the 20 cases of origin of the left coronary artery from the RPA reported in the literature is well known [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (table I).…”