Anomalous origin of the left coronary artery from the pulmonary artery: diagnosis and follow-up evaluation by echocardiography

Abstract

Objective To explore the value of the echocardiography in the diagnosis and follow-up evaluation of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA). Methods Sixty-five patients with ALCAPA were reviewed retrospectively and followed-up after operations. Results Four cases were misdiagnosed. Two of infant-type patients were dead during the follow-up period.Postoperatively, echocardiography demonstrated that left ventricular end diastolic dimension (LVEDD) significantly narrowed in all infant-type patients in short-term and medial-term followed-up [(42.6±1.3)mm vs (36.0±1.5)mm vs (34.2±1.6)mm, P<0.001], left ventricular ejection function(LVEF) improved in short-term follow-up[(30.0±1.6)% vs (37.2±3.0)%, P=0.04] and significantly improved in a median follow-up[(37.2±3.0)% vs (58.6±2.4)%, P<0.001]. Adult-type also had a significant narrowed LVEDD (P<0.001), and none of the patients showed any significant residual mitral insufficiency. Conclusions Echocardiography has important clinical value in diagnosis of ALCAPA, postoperative and follow-up evaluation. Key words: Echocardiography; Heart defects, congenital; Anomalous origin of left coronary artery from pulmonary artery