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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

[Left circumflex coronary aneurysm with separated left main trunk]

Yoshitaka Takeda1, K Kawahito, M Tanaka

  • 1Department of Cardiovascular Surgery, Shonan-Kamakura General Hospital, Kamakura, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 14, 2007
PubMed

Insights

This case study details a rare coronary artery anomaly where the left main coronary artery bifurcated into separate left anterior descending and left circumflex origins. A significant aneurysm and stenosis in the left circumflex artery were successfully treated with ligation and bypass grafting.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Coronary artery anomalies are rare but can lead to significant cardiovascular events.
  • Congenital variations in coronary artery origins require accurate diagnosis for appropriate management.
  • Aneurysms and stenosis in coronary arteries pose a risk of myocardial infarction and sudden cardiac death.

Observation:

  • A 66-year-old male on hemodialysis presented with exertional dyspnea.
  • Coronary angiography and CT revealed separate origins for the left anterior descending (LAD) and left circumflex (LCx) coronary arteries from the left aortic sinus.
  • The LCx exhibited a 2 cm aneurysm with 99% proximal stenosis.

Findings:

  • The patient had a rare coronary anatomical variant: separated left main coronary trunks (LMT).
  • A significant left circumflex coronary aneurysm with critical stenosis was identified.
  • Successful surgical intervention involved aneurysm ligation and coronary artery bypass grafting.

Implications:

  • This case highlights the importance of advanced imaging in diagnosing complex coronary artery anomalies.
  • Surgical management of coronary aneurysms and stenosis in anomalous origins can be effective.
  • Understanding such variations is crucial for preventing adverse cardiac events in affected individuals.

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