Intermediate Outcomes After Repair of Anomalous Left Coronary Artery From the Pulmonary Artery

Radman, Monique; Mastropietro, Christopher W.; Costello, John M.; Amula, Venugopal; Flores, Saúl; Caudill, Elizabeth; Karki, Karan; Migally, Karl; Narasimhulu, Sukumar Suguna; Piggott, Kurt D.; Sassalos, Peter; Wilhelm, Michael; Moser, Elizabeth A. S.; Cashen, Katherine; Badheka, Aditya; Bakar, Adnan; Buckley, Jason R.; Chiwane, Saurabh; Gray, Margaret A.; Iliopoulos, Ilias; Lucas, John F.; Kwiatowski, David M.; Gowda, Keshava Murthy Narayana; Riley, Christine; Smerling, Jennifer

doi:10.1016/j.athoracsur.2020.06.130

Cited by 16 publications

(7 citation statements)

References 22 publications

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“…The long-term prognosis of patients with isolated ALCAPA is reported to be good [ 20 , 21 ]. A large series describing more than 100 patients four years after corrective surgery reported very low mortality and normalization of the LV function in almost all patients [ 21 ].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Aberrant left coronary artery from the pulmonary artery with patent ductus arteriosus - a case report and review of the literature

Amer,

Shai,

Assa

et al. 2024

J Cardiothorac Surg

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Background Aberrant left coronary artery from pulmonary artery (ALCAPA) is a very rare congenital heart defect. Its coexistence with patent ductus arteriosus (PDA) is extremely rare. The high pressures created by the left-to-right shunt in the pulmonary arteries can delay symptoms and create a real challenge in diagnosing ALCAPA. Missing this diagnosis can have severe results, including extensive ischemia and sudden death. Case presentation We present a case of an infant born with a large PDA. Initially treated conservatively, however, due to congestive heart failure and lack of weight gain, she underwent surgical ligation of the PDA at the age of four and a half months. Following surgery, she developed pulmonary edema. Echocardiography revealed decreased ventricular function. ECG revealed ST elevations on lateral leads, and serum troponin was significantly increased. The patient underwent cardiac magnetic resonance imaging (MRI), which revealed signs of wall ischemia and decreased function of the left ventricle (LV) with unclear coronary anatomy. Diagnostic catheterization revealed an ALCAPA. She underwent surgical intervention, and the left coronary artery was re-implanted in the aortic sinus. Follow-up revealed slow improvement of cardiac function. Discussion and literature review The coexistence of PDA and ALCAPA is a very rare occurrence. We found at least 10 reported cases in the literature. Delayed diagnosis might be detrimental. The prognosis of these patients is variable. Conclusion An unusual post-surgical course following PDA repair requires a high index of suspicion and appropriate evaluation for ALCAPA, preferably with angiography.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Aberrant left coronary artery from the pulmonary artery with patent ductus arteriosus - a case report and review of the literature

Amer,

Shai,

Assa

et al. 2024

J Cardiothorac Surg

View full text Add to dashboard Cite

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“…For surviving patients, prognosis appears to be good, although it was only described in four of the seven living cases (14,(16)(17)(18). The long-term prognosis of patients with isolated ALCAPA is reported to be good (20,21). A large series describing more than 100 patients four years after corrective surgery reported very low mortality and normalization of the LV function in almost all patients (21).…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Aberrant left coronary artery from the pulmonary artery with patent ductus arteriosus - A case report and review of the literature

Amer,

Shai,

Assa

et al. 2024

Preprint

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Background: Aberrant left coronary artery from pulmonary artery (ALCAPA) is a very rare congenital heart defect. Its coexistence with patent ductus arteriosus (PDA) is extremely rare. The high pressures created by the left-to-right shunt in the pulmonary arteries can delay symptoms and create a real challenge in diagnosing ALCAPA. Missing this diagnosis can have severe results, including extensive ischemia and sudden death. Case presentation: We present a case of an infant born with a large PDA. Initially treated conservatively; however, due to congestive heart failure and lack of weight gain, she underwent surgical ligation of the PDA at the age of four and a half months. Following surgery, she developed pulmonary edema. Echocardiography revealed decreased ventricular function. ECG revealed ST elevations on lateral leads, and serum troponin was significantly increased. The patient underwent cardiac magnetic resonance imaging (MRI), which revealed signs of wall ischemia and decreased function of the left ventricle (LV) with unclear coronary anatomy. Diagnostic catheterization revealed an ALCAPA. She underwent surgical intervention, and the left coronary artery was re-implanted in the aortic sinus. Follow-up revealed slow improvement of cardiac function. Discussion and literature review: The coexistence of PDA and ALCAPA is a very rare occurrence. We found at least 10 reported cases in the literature. Delayed diagnosis might be detrimental. The prognosis of these patients is variable. Conclusion: An unusual post-surgical course following PDA repair requires a high index of suspicion and appropriate evaluation for ALCAPA, preferably with angiography.

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“…[ 4 ] The largest and most contemporary cohort of ALCAPA was reported by Radman et al There were 170 patients who survived to discharge and the LV function normalized in 79% by 1 year and 97% by 3 years. [ 9 ] However, these studies used the motion mode (M-mode) echocardiography to assess LV function, and the trajectory of LV function improvement in the 1 st year after surgery was not reported.…”

Section: Discussionmentioning

confidence: 99%

The utility of speckle-tracking echocardiography in early and midterm follow-up after anomalous origin of the left coronary artery from the pulmonary artery repair

Krishna,

Jothinath,

Raju

2023

Annals of Pediatric Cardiology

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Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a reversible cause of left ventricular (LV) dysfunction in infants. The LV function is expected to improve serially and return to normal by 1 year after surgical repair. The pattern of improvement in LV function has not been serially analyzed after ALCAPA repair. We report our preliminary experience with serial assessment of LV function in infants undergoing ALCAPA repair utilizing speckle tracking echocardiography.

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Intermediate Outcomes After Repair of Anomalous Left Coronary Artery From the Pulmonary Artery

Cited by 16 publications

References 22 publications

Aberrant left coronary artery from the pulmonary artery with patent ductus arteriosus - a case report and review of the literature

Aberrant left coronary artery from the pulmonary artery with patent ductus arteriosus - a case report and review of the literature

Aberrant left coronary artery from the pulmonary artery with patent ductus arteriosus - A case report and review of the literature

The utility of speckle-tracking echocardiography in early and midterm follow-up after anomalous origin of the left coronary artery from the pulmonary artery repair

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