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Suresh V Joshi, Abhijeet V Naik, Parag S Bhalgat, Bhushan Chavan, Prasanna Salvi
BACKGROUND: Anomalous origin of left coronary artery from pulmonary artery is a very rare disease with incidence of one every 300,000 live births. It has a high mortality of 80% in the first year of life. This observational study summarized our experience using the technique of subclavian arterial bypass without the use of cardiopulmonary bypass (CPB) for treatment of this coronary anomaly in pediatric population. The study aims to revive an earlier technique, with modifications, as an alternative to the existing coronary translocation...
September 2016: Indian Heart Journal
K L Yew, Z Kang, A Anum
Coronary artery anomalies are often discovered incidentally during cardiac catheterization or computed tomography coronary angiography and may involve the affected coronary artery origin and its course. Coronary artery anomalies are associated with congenital heart disease. The affected coronary arteries may have an unusual high take off origin, origin from contralateral or non-coronary sinus, origin from the pulmonary artery, single coronary system or coronary artery fistula.
August 2016: Medical Journal of Malaysia
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
Amirreza Sajjadieh Khajouei, Mohammadreza Samie-Nasab, Mohaddeseh Behjati, Robert W Biederman
Untreated ALCAPA cases most often die in infancy. Adults with untreated ALCAPA commonly present with mitral regurgitation, severe left ventricular dysfunction, and sometimes myocardial infarction. Herein, we present an asymptomatic adult female with ALCAPA recognized through cardiac computed tomography (CT). In ALCAPA, like other coronary anomalies, cardiac CT is often instrumental in providing unique noninvasive and clinically relevant evaluation. Herein, we present an atypical presentation of an asymptomatic middle-aged adult female with ALCAPA...
September 16, 2016: Echocardiography
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
Tyler H Harris, Jeffrey G Gossett
Care of adults with coronary artery disease focuses on troponins to rapidly move patients to catheterization. Troponins are increasingly drawn in children, but emergent catheterization may not be indicted. We sought to establish etiologies of troponin elevation and ascertain the yield of diagnostic tests, in this population. Retrospective review of patients from January 1, 2002, to December 31, 2011, who had any elevated troponin during the study period. Patients were excluded for recent cardiac surgery, "significant" congenital heart disease, if they were neonates in the NICU or were on ECMO...
August 29, 2016: Pediatric Cardiology
Giovanni Di Salvo, Ghassan Siblini, Ziad Issa, Habdan Mohammed, Anas Abu Hazeem, Valeria Pergola, Nisreen Muhanna, Naif Al Qweai, Domenico Galzerano, Bahaa Fadel, Majid Fayyadh, Mansour Joufan, Zohair Halees, Ziad Bulbul
OBJECTIVE: Our aim was to evaluate left ventricular (LV) mechanics by using speckle tracking echocardiography (STE) in asymptomatic patients with abnormal origin of the left main coronary artery from the pulmonary trunk (ALCAPA), late after successful repair, in the presence of LV ejection fraction (EF) >50%. METHODS: We studied 30 ALCAPA patients (median age 4 years, range 1-25 years, NYHA class I, LVEF >50%) and 16 healthy age- and sex-matched controls (median age 5 years, range 1-25 years)...
August 26, 2016: Cardiology
Yunfei Ling, Sandeep Bhushan, Qiang Fan, Menglin Tang
BACKGROUND: This study was undertaken to determine the midterm outcome in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) undergoing coronary reimplantation and Takeuchi repair. METHODS: A retrospective review of patients who had ALCAPA repair between January 2009 and December 2015. Mortality, echocardiography assessment of left ventricular function including ejection fractionand, shortening fraction, severity of mitral regurgitation, stenosis of the coronary ostium were studied retrospectively...
August 26, 2016: Journal of Cardiothoracic Surgery
Luis Gustavo Vilá Mollinedo, Andrés Jaime Uribe, José Luis Aceves Chimal, Roberto Pablo Martínez-Rubio, Karen Patricia Hernández-Romero
Anomalous left coronary artery from the pulmonary artery, or ALCAPA syndrome, is a rare congenital cardiac disease that can cause myocardial infarction, heart failure and even death in paediatric patients. Only few untreated patients survive until adult age. Here we present the case of a 33-year-old female patient with paroxysmal tachycardia, syncope and mild exertional dyspnoea. She was diagnosed with ALCAPA syndrome and underwent surgical correction with an alternative technique of left main coronary artery extension to the aorta...
2016: F1000Research
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
S Michael Roberts, Trey Banbury, Anand Mehta
Anomalous left coronary artery from the pulmonary artery (ALCAPA), or Bland-White-Garland syndrome, is a rare congenital coronary anomaly that results in altered myocardial perfusion and a left to right shunt. It occurs in 1:300000 live births and represents 0.24% to 0.46% of all congenital cardiac diseases. Despite its rarity, it is one of the most common causes of ischemia and infarction in children. Ninety percent of these patients will die within the first year of life if untreated and diagnosing this abnormality in adulthood is extremely rare...
July 9, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
J D Simmonds, M Mustafa, D P Fajardo Jaramillo, H R Bellsham-Revell, J Marek, M Burch, V T Tsang, N Muthialu
With the imbalance between donation rates and potential recipients growing, transplant programs are increasingly using non-ideal organs from so-called marginal donors. This is the first reported case of the intentional use of a donor heart with ALCAPA. The recipient was aged one yr with restrictive cardiomyopathy who had been supported with BiVAD for over six months. Function of the donor left ventricle was shown to be well preserved, with no obvious signs of ischemia, except for a fibrotic layer on the anterolateral papillary muscle of the mitral valve...
September 2016: Pediatric Transplantation
Narihiro Ishida, Katsuya Shimabukuro, Hiroki Ogura, Hirofumi Takemura, Kiyoshi Doi
Anomalous left coronary artery from the pulmonary artery (ALCAPA) in adults is a rare congenital coronary abnormality. We report a case of ALCAPA in a 73-year-old female managed by total arterial revascularization. doi: 10.1111/jocs.12755 (J Card Surg 2016;31:380-382).
June 2016: Journal of Cardiac 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)
Tracie C Walker, Markus S Renno, David A Parra, Scott O Guthrie
An anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac condition that typically presents with poor feeding and failure to thrive from progressive myocardial ischaemia. Previous reports of ALCAPA presenting with ventricular fibrillation (VF) have suggested a causative relationship. In this case, we present a neonate with VF without apparent cause after an extensive evaluation. Following implantable cardioverter-defibrillator placement for presumed idiopathic VF, at which time she also underwent surgical ligation of a patent ductus arteriosus (PDA), the neonate developed haemodynamic instability that ultimately was found to be due to ALCAPA...
March 31, 2016: BMJ Case Reports
Hassane Abdallah, Ismail Bouhout, Samuel St-Onge, François-Pierre Mongeon, Philippe Demers
Late presentation of an anomalous left coronary artery from the pulmonary artery (ALCAPA) is uncommon because patients rarely survive past infancy. We present a case of symptomatic ALCAPA associated with decreased myocardial contractility in a 68-year-old woman. The patient underwent reimplantation of the left coronary artery in the aortic root.
December 28, 2015: Canadian Journal of Cardiology
Phillip S Naimo, Tyson A Fricke, Yves d'Udekem, Andrew D Cochrane, Andrew Bullock, Terry Robertson, Christian P Brizard, Igor E Konstantinov
BACKGROUND: Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect with limited data on long-term outcomes after surgical intervention. METHODS: We conducted a retrospective review of all children (N = 42) who underwent surgical repair of ALCAPA between 1980 and 2014 at the Royal Children's Hospital, Melbourne. RESULTS: Twenty-nine (69% [29 of 42]) patients underwent coronary reimplantation, 12 (29% [12 of 42]) had intrapulmonary baffle (Takeuchi) repair, and 1 (2% [1 of 42]) patient had ligation of the anomalous coronary artery...
May 2016: Annals of Thoracic Surgery
Wei Gao, Yu Min Zhong, Ai Min Sun, Qian Wang, Rong Zhen Ouyang, Li Wei Hu, Han Sheng Qiu, Shi Yu Wang, Jian Ying Li
To explore the clinical value and evaluate the diagnostic accuracy of sub-mSv low-dose prospective ECG-triggering cardiac CT (CCT) in young infants with complex congenital heart disease (CHD). A total of 102 consecutive infant patients (53 boys and 49 girls with mean age of 2.9 ± 2.4 m and weight less than 5 kg) with complex CHD were prospectively enrolled. Scans were performed on a 64-slice high definition CT scanner with low dose prospective ECG-triggering mode and reconstructed with 80 % adaptive statistical iterative reconstruction algorithm...
June 2016: International Journal of Cardiovascular Imaging
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