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Anomalous origin of the left coronary artery from the pulmonary artery
A Sarioğlu1, I L Saltik, G Sağin-Saylam
1Istanbul University Institute of Cardiology.
Insights
Anomalous left coronary artery from the pulmonary artery (ALCA-PA) is a rare congenital heart defect. This report details three cases, including the first reported infantile ALCA-PA cases in Turkey, treated with aorto-pulmonary tunnel repair.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Anomalous left coronary artery from the pulmonary artery (ALCA-PA) is a rare congenital heart anomaly.
- It can lead to significant myocardial ischemia and infarction, particularly in infancy.
- Early diagnosis and surgical intervention are crucial for patient outcomes.
Observation:
- This report describes three pediatric cases of ALCA-PA.
- Two infants presented with heart failure due to myocardial ischemia and infarction.
- A third patient, asymptomatic, was diagnosed with ALCA-PA after surgery for other cardiac defects.
Findings:
- All three patients underwent successful aorto-pulmonary tunnel repair (Tukeuchi procedure).
- This study reports the first infantile cases of ALCA-PA treated surgically in Turkey.
- The varied presentations highlight the spectrum of ALCA-PA clinical manifestations.
Implications:
- The Tukeuchi procedure is an effective surgical option for ALCA-PA.
- Increased awareness of ALCA-PA is needed for timely diagnosis in infants and children.
- This case series contributes valuable data on ALCA-PA management in a specific geographic region.
Abstract:
Anomalous origin of the left coronary artery from the pulmonary artery (ALCA-PA) is a rare form of congenital heart disease. In this report, three cases with this anomaly are described; two patients presented in infancy with heart failure from myocardial ischemia and infarction, while the third was asymptomatic and ALCA-PA was diagnosed during evaluation of a residual murmur after surgery for associated cardiac defects (ventricular septal defect and patent arterial duct). All three cases underwent aorto-pulmonary tunnel repair (Tukeuchi procedure), and to our knowledge two of them are the first infantile cases reported in Turkey.