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Title: | Anomalous Left Coronary Artery From the Distal Right Pulmonary Artery | Authors: | Mahawattege, A. Kim, D. Shearer, L. |
Issue Date: | 2024 | Source: | Heart Lung and Circulation, 2024 (33) p.S489 | Pages: | S489 | Journal Title: | Heart Lung and Circulation | Abstract: | Background Anomalous origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) is a rare congenital cardiac disease; even rarer ALCAPA from the distal Right Pulmonary Artery (RPA). Case summary A 5-month-old boy presented with symptoms of fatigue, diaphoresis, and dyspnoea with feeds. Examination demonstrated heart failure with mild respiratory distress and hepatomegaly, gallop rhythm and an apical 3/6 pansystolic murmur. Transthoracic Echocardiogram (TTE) identified a small perimembranous ventricular septal defect, severe mitral regurgitation with echogenic papillary muscles, a significantly dilated left atrium and ventricle with normal systolic function. There was retrograde flow through the left anterior descending artery to the circumflex artery and prominent transseptal collateralisation, with no left main coronary artery seen arising from the aortic root. Cardiac CT demonstrated an abnormal coronary artery connection between the posteroinferior aspect of the distal RPA, traversing along the superior aspect of the left atrium to the branching of the anterior descending and circumflex arteries. Subsequent TTE demonstrated flow from this coronary artery into the RPA. The patient underwent successful surgical translocation of the anomalous left coronary artery from the distal RPA to the aorta, VSD closure, posterior mitral valve commissuroplasty and Alfieri repair. Conclusion This case highlights the rare variant of ALCAPA and the importance of a high index of suspicion in infants with mitral regurgitation. Preserved systolic function was possibly due to the younger age at presentation. The distal site of origin is a challenging diagnosis to make echocardiographically and highlights the utility of cardiac CT for diagnosis. | DOI: | 10.1016/j.hlc.2024.06.793 | Resources: | https://www.embase.com/search/results?subaction=viewrecord&id=L2033531510&from=export http://dx.doi.org/10.1016/j.hlc.2024.06.793 |
Type: | Conference Abstract |
Appears in Sites: | Children's Health Queensland Publications Queensland Health Publications |
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