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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)
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[Anomalous left main coronary artery with an inter-aorto-pulmonary trajectory: diagnostic value of 64-slice CT scan

P Ou1, M Jemmali, D Marini

  • 1Radiologie pédiatrique, Université René Descartes, Paris 5, Hôpital Necker-Enfants Malades, Paris. phalla.ou@nck.ap-hop-paris.fr

Archives Des Maladies Du Coeur Et Des Vaisseaux
|July 25, 2007
PubMed

Insights

An anomalous left coronary artery originating from the right sinus can cause sudden death in young adults. A CT scan effectively diagnosed this rare condition in a child experiencing exertional syncope and angina.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Pediatric Cardiology

Background:

  • Anomalous left coronary artery from the right sinus of Valsalva with an interarterial course is a rare congenital anomaly.
  • This malformation can lead to myocardial ischemia and sudden cardiac death, particularly in young individuals, due to compression between the aorta and pulmonary artery during exercise.

Observation:

  • A 12-year-old child presented with exertional syncope and angina, indicative of myocardial ischemia.
  • Diagnostic imaging revealed an anomalous left coronary artery arising from the right aortic sinus with an inter-aorto-pulmonary trajectory.

Findings:

  • Computed Tomography (CT) scan with 3-D reconstruction confirmed the diagnosis of anomalous left coronary artery.
  • The CT scan precisely delineated the aberrant coronary artery's trajectory and its anatomical relationship with the great vessels at the heart's base.

Implications:

  • Cardiac CT is the preferred imaging modality for diagnosing congenital coronary anomalies and for preoperative planning.
  • CT angiography offers superior visualization of coronary anatomy compared to echocardiography and conventional angiography in suspected cases.

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