Anomalous Left Coronary Artery

ABCIC

Case Report

Rare Incidental Finding on Coronary Artery CT Angiography: Left Main Coronary Artery Atresia

Maria Eduarda Menezes de Siqueira et al. Mayra Isabel Dias Ana Claudia Vincezi Raudan Uski Luciano Figueiredo de Aguiar Filho

Introduction

Congenital left main coronary artery atresia (CLMCAA) is a coronary anomaly in which the left coronary ostium or trunk is absent. The anterior descending (AD) and circumflex (CX) arteries are usually connected and proximally end blindly. Left chamber perfusion is provided by the right coronary (RC) collaterals. It is the rarest coronary anomaly, with fewer than 70 cases described in the literature. The clinical CLMCAA spectrum ranges from asymptomatic cases (due to an efficient collateral system) to symptoms such as angina, tachyarrhythmias, syncope, and sudden death.^, Surgical revascularization is recommended in symptomatic patients; however, preventive surgical treatment is controversial in asymptomatic patients without inducible myocardial ischemia.^–

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ABC

Original Article

Anomalous origin of the left coronary artery from the pulmonary trunk. Clinical features and midterm results after surgical treatment

Fernando Amaral et al. Julene S. Carvalho João A. Granzotti Elliot A. Shinebourne

OBJECTIVE: To report the authors’ experience with the anomalous origin of the left coronary artery (AOLCA) from the pulmonary trunk, emphasizing preoperative data, surgical aspects and midterm results of the follow-up. METHODS: Retrospective analysis of 11 patients operated upon at the Royal Brompton Hospital from October, 84 to April, 97. RESULTS: Nine infants had heart failure (HF) and two other children presented with dyspnea and chest pain. All had ECG changes. The echocardiogram identified the anomalous origin of the coronary artery in 7 (64%) patients and hemodynamic studies were performed in 7 patients. All infants were operated upon between the 2nd and 10th month of life. Six patients were treated with aortic reimplantation of the left coronary artery, whereas five were operated upon according to the Takeuchi technique. All patients are alive, with clear improvement of the ECG changes and ventricular function, as evaluated by echocardiography. Two patients operated upon according to the Takeuchi technique required additional surgery due to severe supravalvular pulmonary stenosis. CONCLUSION: AOLCA is a rare disease. Most patients show early signs of severe HF associated with ECG findings. Surgical therapy must be instituted early in the disease, preferentially through aortic implantation of the anomalous coronary artery, with a high possibility of success. Shortly after surgery, clinical and ECG improvement, as well as normalization of left ventricular function, should be expected.

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Rare Incidental Finding on Coronary Artery CT Angiography: Left Main Coronary Artery Atresia

Introduction

Anomalous origin of the left coronary artery from the pulmonary trunk. Clinical features and midterm results after surgical treatment

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)