Abstract
Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually presents in childhood. It results in left ventricular (LV) ischemia with resulting LV dysfunction. This ischemia results from retrograde flow into the pulmonary artery which can act as a coronary steal. We here report antegrade flow detected in ALCAPA caused by severe pulmonary hypertension. Anatomic correction of ALCAPA is the preferred surgical option and should be performed as early as possible.
Highlights
Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually presents in childhood, known as Bland-White-Garland syndrome, occurring in approximately 1 in 300,000 children or 0.5% of children with congenital heart disease
Clinical manifestations of ALCAPA are due to myocardial ischemia, secondary to low-pressure coronary perfusion and insufficient collateral flow from the right coronary artery and reversed flow in the left coronary vessels to the pulmonary artery, which can cause coronary steal.[3]
In the patient presented here the presence of ALCAPA with primary mitral valve abnormality resulted in several unusual features
Summary
Antegrade flow in Anomalous Left Coronary Artery from Pulmonary Artery: Clinical implications. Yasser Sedky[1], Hatem Hosny[2], Mohamed Donya[3], Sherin AbdElsalam[1], Magdi Yacoub4,*
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