Successful percutaneous treatment of anomalous left coronary artery from pulmonary artery

Collins, Nicholas; Colman, Jack M.; Benson, Lee; Hansen, Mark; Merchant, Naeem; Horlick, Eric

doi:10.1016/j.ijcard.2006.11.075

Cited by 40 publications

(14 citation statements)

References 7 publications

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“…Surgical treatment should be performed once the diagnosis is made, with the aim of creating a dual coronary arterial system, thus minimizing the occurrence and the extension of myocardial ischemia 7,8 . The surgical method of choice is the reimplantation of the LCA into the aorta, either directly or through elongation of the anomalous artery by creating a tube‐shaped graft using part of the contiguous pulmonary arterial wall.…”

Section: Discussionmentioning

confidence: 99%

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

Lopes¹,

Almeida²,

Amorim

et al. 2011

Congenital Heart Disease

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Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly with a mortality of 90% in the first year of life, if not surgically corrected. Adult presentation of the anomalous origin of the left coronary artery from the pulmonary artery syndrome is extremely rare but may occur if a well-developed collateral circulation from right coronary artery is present. We present the case of a 22-year-old asymptomatic female with anomalous origin of the left coronary artery from the pulmonary artery.

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Section: Discussionmentioning

confidence: 99%

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

Lopes¹,

Almeida²,

Amorim

et al. 2011

Congenital Heart Disease

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show abstract

“…Though a transcatheter closure of ALCAPA has been recently reported as a potentially safe and effective alternative treatment [7], direct re-implantation is considered as the first line surgical option nowadays, as it yields a more anatomical position by connecting the left coronary artery (LCA) to aorta.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)

Secinaro

Ntsinjana

Tann

et al. 2011

Journal of Cardiovascular Magnetic Resonance

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BackgroundAnomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare coronary artery anomaly. This study shows the role of cardiovascular magnetic resonance (CMR) in assessing young patients following surgical repair of ALCAPA.Methods6 patients, aged 9-21 years, with repaired ALCAPA (2 Tackeuchi method, 4 direct re-implantation) underwent CMR because of clinical suspicion of myocardial ischemia. Imaging used short and long axis cine images (assess ventricular function), late-gadolinium enhancement (LGE) (detect segmental myocardial fibrosis), adenosine stress perfusion (detect reversible ischaemia) and 3D whole-heart imaging (visualize proximal coronary arteries).ResultsThe left ventricular (LV) global systolic function was preserved in all patients (mean LV ejection fraction = 62.7% ± 4.23%). The LV volumes were within the normal ranges, (mean indexed LVEDV = 75.4 ± 3.5 ml/m2, LVESV = 31.6 ± 9.4 ml/m2). In 1 patient, hypokinesia of the anterior segments was visualized. Five patients showed sub-endocardial LGE involving the basal, antero-lateral wall and the anterior papillary muscle. Three patients had areas of reversible ischemia. In these 3, 3D whole-heart MRA showed that the proximal course of the left coronary artery was occluded (confirmed with cardiac catheterisation).ConclusionsCMR is a good, non-invasive, radiation-free investigation in the post-surgical evaluation of ALCAPA. In referred patients we show that basal, antero-lateral sub-endocardial myocardial fibrosis is a characteristic finding. Furthermore, stress adenosine CMR perfusion, can identify reversible ischemia in this group, and was indicative of left coronary artery occlusion.

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“…Ligation of the anomalous artery at its origin in order to prevent coronary steal phenomena is one option, but this method depends on extensive collateral supply from the right coronary artery. An alternative percutaneous treatment approach was recently introduced by which the left coronary artery was closed by device embolization in a patient with large collaterals and coronary steal phenomena [7]. Ideally, the surgical procedures should be aimed at creating a two-coronary system either via 1) a bypass graft (mammary artery or saphenous vein) in combination with ligation of the anomalous artery, 2) the Takeuchi-procedure where an intrapulmonary tunnel from the aortopulmonary window to the coronary artery is created or 3) translocation of the left coronary artery from the pulmonary trunk to the aortic sinus [8,9].…”

Section: Discussionmentioning

confidence: 99%

Anomalous origin of left main coronary artery from pulmonary artery in an adult: Peri-operative concerns

Nath

Kiran

Talwar

2010

Indian J Thorac Cardiovasc Surg

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Anomalous origin of the left coronary artery from the pulmonary artery is an infrequent and lethal anomaly which can be alleviated surgically. However, its timely diagnosis is important. The management of such patients is challenging for cardiac surgeons and anesthesiologists as they are vulnerable to myocardial ischemia from coronary steal, left ventricular dysfunction, dysrhythmias and pulmonary hypertension. In this report, we present an adult patient who underwent successful surgery for this anomaly. Clinical presentation, diagnosis and anesthetic management of such patients is discussed.

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Successful percutaneous treatment of anomalous left coronary artery from pulmonary artery

Cited by 40 publications

References 7 publications

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

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

Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)

Anomalous origin of left main coronary artery from pulmonary artery in an adult: Peri-operative concerns

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