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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Percutaneous coronary intervention with stent deployment in anomalously-arising left circumflex coronary arteries

Nick E J West1, Charles J McKenna, Oliver Ormerod

  • 1Department of Cardiology, John Radcliffe Hospital, Oxford, UK. nick.west@glos.nhs.uk

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 7, 2006
PubMed

Insights

Anomalous left circumflex coronary arteries commonly develop atherosclerotic disease in their retroaortic segment. Percutaneous coronary intervention (PCI) is feasible for treating this condition, offering favorable outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Anomalous origin of the left circumflex coronary artery (ALCAC) is the most common congenital coronary anomaly.
  • The predisposition of ALCAC to proximal atherosclerotic disease is debated.
  • Limited data exist on stent deployment in anomalous circumflex vessels.

Purpose of the Study:

  • To investigate the prevalence of atherosclerotic disease in the retroaortic segment of ALCAC.
  • To evaluate the feasibility and outcomes of percutaneous coronary intervention (PCI) in these vessels.

Main Methods:

  • Retrospective case study of 22 patients with ALCAC.
  • Twelve patients underwent PCI with stent deployment in the retroaortic segment.
  • Analysis of coronary disease and procedural success.

Main Results:

  • 73% of ALCAC vessels showed significant obstructive disease in the retroaortic portion.
  • PCI was successful in all attempted cases.
  • Favorable short- to medium-term event-free survival was observed.

Conclusions:

  • The retroaortic segment of ALCAC is selectively prone to atherosclerosis.
  • PCI is a feasible treatment option for ALCAC with obstructive disease.
  • PCI in these vessels can be technically challenging.
Abstract

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