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Anomalous origin of the left pulmonary artery

Jignesh Kothari, Ketav Lakhia, Parth Solanki, Divyakant Parmar, Hiren Boraniya, Sanjay Patel
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular a rrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Santosh Kumar Sinha, Dibbendhu Khanra, Mukesh Jitendra Jha, Karandeep Singh, Mahamdulla Razi, Amit Goel, Vikas Mishra, Mohammad Asif, Mohit Sachan, Nasar Afdaali, Ashutosh Kumar, Ramesh Thakur, Vinay Krishna, Umeshwar Pandey, Chandra Mohan Varma
ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and unusual survival to adulthood. We report a 73-year-old woman with ALCAPA who presented with exertional dyspnea (NYHA functional class II) over past 2 years. Physical examination revealed soft S, long mid diastolic rumbling murmur and apical pan-systolic murmur. Electrocardiography displayed biatrial enlargement and poor R progression and normal sinus rhythm...
October 2016: Journal of Clinical Medicine Research
Anneke Neumann, Samir Sarikouch, Dmitry Bobylev, Luitgard Meschenmoser, Thomas Breymann, Mechthild Westhoff-Bleck, Michael Scheid, Ioannis Tzanavaros, Harald Bertram, Philipp Beerbaum, Axel Haverich, Dietmar Boethig, Alexander Horke
OBJECTIVES: We evaluated long-term results of two different repair strategies of anomalous origin of left coronary artery from pulmonary artery (ALCAPA) in two German surgical centres. METHODS: We performed a retrospective review of patients who underwent ALCAPA repair between November 1980 and October 2012. Ventricular function was assessed by standardized transthoracic echocardiographic studies. RESULTS: A total of 30 patients with a median age of 0...
September 9, 2016: European Journal of Cardio-thoracic Surgery
Rashid Saif Al Umairi, Faiza Al Kindi, Fadhila Al Busaidi
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality also known as Bland-White-Garland syndrome. The incidence of ALCAPA is about 1 in every 300,000 live births, and constitutes 0.24% and 0.46% of all congenital cardiac disease. It has a high infant mortality rate reaching up to 90% if left untreated. For many years, the diagnosis of ALCAPA was by angiography or autopsy. However, multislice computed tomography (MSCT) is a non-invasive imaging tool that allows accurate, non-invasive diagnosis of ALCAPA...
September 2016: Oman Medical Journal
Adam Wheeler, Dan Vu, Pierangelo Renella
We present a case of an ex-30 week premature male infant diagnosed postnatally with Tetralogy of Fallot, hemitruncus, and discontinuous pulmonary arteries (PAs) at 6 days of life. The patient was diagnosed by echocardiography, and the diagnosis was confirmed on subsequent dual-energy chest CT angiogram. In our patient, the left PA arose directly from the aorta, whereas the right PA originated normally from the right ventricular outflow tract. At 9 days of life, he underwent successful surgical palliation with placement of a modified Blalock-Taussig (aortopulmonary) shunt from the base of the left subclavian artery to the anomalously connected left PA along with anastomosis together of the right and left branch PAs to establish continuity with the main PA...
September 2016: Radiology case reports
Jiawei Qiu, Shoujun Li, Jun Yan, Qiang Wang, Yunhu Song, Hansong Sun, Dianyuan Li
BACKGROUND: Anomalous origin of coronary artery from the pulmonary artery (ACAPA) is a rare congenital coronary malformation with a high mortality whether in infants or adult patients. This study reviews 20years of surgical treatment in a single center and aims to establish the optimal surgical strategies for this rare pathology. METHODS AND RESULTS: From April 1994 to March 2015, 96 consecutive patients aged from 3months to 60years underwent coronary repair surgery...
November 15, 2016: International Journal of Cardiology
Aditi Vohra, Harneet Narula
Dual left anterior descending artery is a rare coronary artery anomaly showing two left anterior descending arteries. Short anterior descending artery usually arises from the left coronary artery, while long anterior descending artery has anomalous origin and course. Dual left anterior descending artery with origin of long anterior descending artery from the pulmonary artery (ALCAPA) is a very rare coronary artery anomaly which has not been reported previously in the literature. We present the computed tomography coronary angiographic findings of this rare case in a young female patient who presented with atypical chest pain...
April 2016: Indian Journal of Radiology & Imaging
Akira Kurosu, Kazumi Kuroyanagi, Shinobu Yamauchi, Kazunobu Omura, Kazuyuki Saito
Anomalous origin of the coronary artery (AOCA) is a rare, but important cause of sudden cardiac death among young athletes. Nine autopsy cases (8 male, 1 female; mean age, 17.9 years; age range, 11-31 years) of sudden death during or just after exercise caused by AOCA were reviewed. The exercises performed at the time of death were running (4 cases), soccer (2 cases), and baseball, swimming and kendo (Japanese swordsmanship) (1 case each). In 6 cases, the left coronary artery arose from the right sinus of Valsalva, and in 3, the right coronary artery from the left sinus...
March 2016: Journal of Forensic Sciences
Yoshimasa Uno, Ayumu Masuoka, Kentaro Hotoda, Toshiyuki Katogi, Takaaki Suzuki
OBJECTIVE: In recent years, the median sternotomy approach with cardiopulmonary bypass has been increasingly chosen when systemic-pulmonary shunt surgery is performed as initial palliation for congenital heart diseases with decreased pulmonary blood flow to secure a stable surgical field and to maintain a stable circulation and oxygen supply. Since 2007, this strategy has been applied in our institute. This time, we examine the advantage and disadvantage of this procedure by evaluating the intraoperative and postoperative courses...
October 2016: General Thoracic and Cardiovascular Surgery
Shu-Shui Wang, Xin-Xin Chen, Ji-Mei Chen, Zhi-Wei Zhang, Ying Ma, Mei-Ping Huang, Jian Zhuang
An anomalous origin of the left coronary artery (LCA) is a relatively uncommon congenital heart defect that can lead to myocardial ischemia and sudden cardiac death. An LCA arising from the pulmonary artery and an LCA arising from the opposite sinus of Valsalva are the common types of anomalous origins of the LCA. Echocardiographic assessment of the coronary arteries is an important component of the routine cardiovascular evaluation, but echocardiographic "pseudo images" of LCA origination can be present in some patients...
August 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Shyam Sathanandam, T K Susheel Kumar, Alexander Feliz, Christopher J Knott-Craig
We report a case of an infant who was postnatally diagnosed with hypoplastic left heart syndrome and an intact atrial septum who underwent emergent atrial decompression followed by the Norwood operation. She was also found to have a congenital diaphragmatic hernia on the left side and a congenital eventration of the right diaphragm, both requiring surgical repair. She was later found to have an anomalous origin of the left circumflex coronary artery from the right pulmonary artery that was ligated at the time of the bilateral bidirectional Glenn operation...
July 2016: Annals of Thoracic Surgery
Changwei Zhang, Hao Zhang, Huawei Gao, Xu Wang, Jinping Liu, Yuhong Wang, Shoujun Li
The origin of both coronary arteries from the pulmonary artery is generally a lethal condition from progressive heart failure. We report the clinical and surgical course in a child aged 18 months with this anomaly. The left ventricular ejection fraction was profoundly depressed. The common coronary trunk arose from the right anterior facing sinus. Direct coronary implantation to the aorta was used. The patient's left ventricular function improved to a nearly normal state at the 6-month follow-up visit.
July 2016: Annals of Thoracic Surgery
Ali Refatllari, Ermal Likaj, Selman Dumani, Endri Hasimi, Artan Goda
BACKGROUND: An anomalous origin of the right coronary artery is rarely observed, with a reported incidence between 0.026% and 0.25%. This condition is often completely asymptomatic and is found incidentally during angiographic evaluation for other cardiac diseases. However some patients present with exertion angina or sudden death. Surgical treatment in patients with anomalous RCA is still controversial. Treatment can be conservative, angioplasty or surgery. CASE PRESENTATION: A 59-year-old man was admitted with severe mitral stenosis...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Quanli Shen, Qiong Yao, Xihong Hu
BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. OBJECTIVE: To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. MATERIALS AND METHODS: Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied...
September 2016: Pediatric Radiology
Matthew R Summers, James L Gentry, Gosta Pettersson, Wael A Jaber
No abstract text is available yet for this article.
June 21, 2016: European Heart Journal
Hisashi Sugiyama, Hiroaki Kise, Takako Toda, Minako Hoshiai
We experienced a rare complication where extravasation developed a pseudo-chamber long after the balloon pulmonary angioplasty for supravalvular pulmonary stenosis. A 3-month-old girl was diagnosed with an anomalous origin of the left coronary artery from the pulmonary artery. She underwent the Takeuchi procedure at 10 months of age. During the follow-up, the supravalvular pulmonary stenosis deteriorated, and was treated by balloon pulmonary angioplasty with the double balloon technique catheter at 6 years of age...
April 30, 2016: Heart and Vessels
Justin T Tretter, Eric M Tretter, Daniela Y Rafii, Robert H Anderson, Puneet Bhatla
Isolated anomalies of the branch pulmonary arteries are rare, more often occurring in the setting of complex congenital heart disease. These isolated anomalies are often not identified in the prenatal period. We describe two cases of isolated anomalies of the left pulmonary artery which were identified on fetal echocardiography and confirmed postnatally, an anomalous left pulmonary artery arising from the base of the left-sided brachiocephalic artery in the setting of a right-sided aortic arch, and a left pulmonary artery sling...
August 2016: Echocardiography
Suresh V Joshi, Abhijeet V Naik, Parag S Bhalgat, Prasanna Salvi
We present a six-year follow-up of an infant who underwent a left subclavian artery to left anterior descending artery anastomosis for anomalous origin of the left coronary artery from the pulmonary artery, without the use of cardiopulmonary bypass. The clinical status, echocardiography, angiography, and exercise tolerance with treadmill test were found to be normal. This technique could be a viable alternative to the more established coronary translocation, with lesser morbidity, shorter hospital stay, and lower economic burden, especially in the developing world...
April 20, 2016: World Journal for Pediatric & Congenital Heart Surgery
Rong-Juan Li, Zhonghua Sun, Jiao Yang, Ya Yang, Yi-Jia Li, Zhao-Ting Leng, Guo-Wen Liu, Li-Hong Pu
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and sudden death in adults. Transthoracic echocardiography (TTE) plays an important role in early detection and diagnosis of ALCAPA as a noninvasive modality. However, its diagnostic value is not well studied. The purpose of this study is to determine the performance of TTE in the diagnostic assessment of ALCAPA as compared with coronary CT and invasive coronary angiography...
April 2016: Medicine (Baltimore)
Bo Liu, Dzmitry Fursevich, Matthew C O'Dell, Miguel Flores, Nicholas Feranec
We report a case of anomalous origin of the left circumflex coronary artery arising from the right pulmonary artery resulting in stress-induced cardiac arrest. The patient collapsed after running a 5K race and was resuscitated. Subsequent workup revealed the culprit anatomy, which was successfully treated with surgical ligation. To the authors' knowledge, this is only the second case of this variant coronary anomaly resulting in aborted sudden cardiac death, subsequent surgical ligation, and recovery in a healthy young adult and is the first case treated by ligation alone without coronary bypass...
2016: Curēus
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