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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)

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[Bilateral coronary artery-pulmonary artery fistulas in a case with unstable angina pectoris]

Alper Kepez1, Ergün Bariş Kaya, Kudret Aytemir

  • 1Department of Cardiology, Medicine Faculty of Hacettepe University, Ankara, Turkey.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|May 24, 2008
PubMed

Insights

Rare congenital bilateral coronary artery fistulas, originating from both the left anterior descending and right coronary arteries, were identified in a patient presenting with chest pain. Surgical ligation of these fistulas during coronary artery bypass grafting resolved the condition without complications.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Coronary artery fistulas are uncommon congenital abnormalities.
  • Bilateral fistulas originating from both coronary arteries are exceptionally rare.

Observation:

  • A 58-year-old male presented with exertional chest pain.
  • Coronary angiography revealed a fistula from the left anterior descending artery with adjacent stenosis and another from the right coronary artery ostium.
  • Both fistulas were observed to drain into the pulmonary artery.

Findings:

  • Successful surgical ligation of both coronary artery fistulas was performed.
  • Coronary artery bypass grafting using the left internal mammary artery addressed the left anterior descending artery stenosis.
  • The patient experienced an uncomplicated postoperative recovery.

Implications:

  • This case highlights the successful surgical management of rare bilateral coronary artery fistulas.
  • Early diagnosis and intervention are crucial for managing complex coronary artery anomalies.
  • Surgical ligation offers a viable treatment option for symptomatic coronary artery fistulas.

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