Echocardiographic Marker for Bland-White-Garland Syndrome in Adult

Selmi, Khalifa; Bergaoui, H.; Boujnah, Mohamed Rachid

doi:10.1016/j.echo.2011.03.016

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…Moreover, careful inspection of the coronary arteries is rarely performed in adults. Therefore, easily identifiable echocardiographic markers of ALCAPA might be helpful to avoid misdiagnosis (8)(9)(10). In adult ALCAPA patients, the blood from the high-pressure RCA artery fills the LCA via extensive collaterals and exits the LCA into the PA. RCA is usually ecstatic and easy to be identified.…”

Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Detected by Echocardiography in an Asymptomatic Adult

et al. 2013

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation. It is unusual for an ALCAPA patient to survive to adulthood. We present a case of an asymptomatic 54-year-old woman with this syndrome in which visualization of a markedly enlarged and tortuous right coronary artery and intercoronary collaterals by echocardiography raises suspicion for this disease and subsequently guides a step-by-step diagnosis. The patient lives well without surgery 3 years after diagnosis.Key words: anomalous origin of the left coronary artery from the pulmonary artery, congenital heart disease, echocardiography (Intern Med 52: 233-236, 2013)

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Section: Discussionmentioning

confidence: 99%

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Detected by Echocardiography in an Asymptomatic Adult

et al. 2013

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“…In our patient, transthoracic echocardiography revealed a prominent large ostium in the right coronary artery and multiple turbulent flow in the ventricular septum due to abundant intercoronary collaterals (so‐called steal collaterals). Such echocardiographic findings should raise a high suspicion for this syndrome . However, its differentiation from other coronary anomalies is yet, uncertain.…”

Section: Discussionmentioning

confidence: 95%

“…Such echocardiographic findings should raise a high suspicion for this syndrome. 7,8 However, its differentiation from other coronary anomalies is yet, uncertain. Based on previous reports stating that increased systolic coronary flow in PW Doppler echocardiography is characteristic for ALCAPA, 1 we performed PW Doppler examination of the right coronary ostium and coronary collaterals which also revealed higher coronary flow velocity in systole than diastole.…”

Section: Discussionmentioning

confidence: 99%

Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in the Adult

2013

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect in adults. We report a 38-year-old male presenting with exertional syncope. He was referred for the evaluation of multiple muscular ventricular septal defects diagnosed on an outpatient echocardiogram. Echocardiography revealed mild left ventricular enlargement, abnormal flow-pattern in the ventricular septum and dilatation of the right coronary artery. Pulsed-wave Doppler with sample volume placed in the coronary ostium showed systolic coronary flow predominancy. This unique finding is characteristic for ALCAPA and can differentiate it from other coronary anomalies. Coronary angiography confirmed ALCAPA syndrome. Surgical correction was planned.

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“…The TTE also recorded that the LCA orifice was not visualized and the RCA was deemed exceptionally dilated and ecstatic raising suspicion of a diagnosis of ALCAPA. [ 6 ] Stress perfusion with technetium-99m sestamibi showed a reversible perfusion deficit in the territory expected to be supplied by the LCA. A coronary angiogram, in finality, demonstrated the origin of the LCA from the pulmonary artery [Figures 1 and 2 ] and the dilated RCA.…”

Section: Case Reportmentioning

confidence: 99%

The utility of targeted perioperative transthoracic echocardiography in managing an adult patient with anomalous origin of the left coronary artery-pulmonary artery for noncardiac surgery

2017

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Congenital coronary artery anomalies as a whole are uncommon. Abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is probably the most common congenital coronary defect. An overwhelming majority of the patients with untreated ALCAPA do not survive to adulthood. As yet, there is no consensus on the management of adults with ALCAPA. We describe a patient with breast malignancy and incidentally detected ALCAPA; primacy was given to treatment of the oncologic condition as a first step. Anesthesia management was focused on maintaining adequate collateral coronary perfusion and avoidance of excessive loading of the left ventricle. This was achieved using a simplified transthoracic echocardiography (TTE) protocol at the time of induction of anesthesia; TTE was also used to reconfirm the absence of disturbances in myocardial function at the end of surgery. We sugggest the routine use of tte in managing perioperative care in low resource settings when the underlying cardiac disease is rare and the evidence base if often insufficient.

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Echocardiographic Marker for Bland-White-Garland Syndrome in Adult

Cited by 6 publications

References 6 publications

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Detected by Echocardiography in an Asymptomatic Adult

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Detected by Echocardiography in an Asymptomatic Adult

Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in the Adult

The utility of targeted perioperative transthoracic echocardiography in managing an adult patient with anomalous origin of the left coronary artery-pulmonary artery for noncardiac surgery

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