ACARPA, a rare case of ALCAPA

Area of Science:

• Cardiology
• Congenital Heart Disease
• Vascular Anomalies

Background:

• Anomalous origin of the circumflex coronary artery from the pulmonary artery is an exceedingly rare congenital anomaly.
• Clinical manifestations range from asymptomatic presentation to severe outcomes like arrhythmia and sudden cardiac death.
• Limited data exists regarding optimal therapeutic strategies due to its low prevalence.

Observation:

• A 19-year-old male with a history of vascular ring and mitral valve stenosis presented with symptoms suggestive of coronary anomaly.
• Echocardiography revealed collateral coronary flow, raising suspicion for anomalous coronary artery origin.
• Computed tomography confirmed the anomalous circumflex coronary artery arising from the right pulmonary artery.

Findings:

• The patient was diagnosed with a rare coronary artery anomaly: circumflex coronary artery originating from the right pulmonary artery.
• Echocardiography and computed tomography were crucial in diagnosing this rare vascular anomaly.
• Surgical reimplantation of the anomalous circumflex coronary artery was performed.

Implications:

• Successful surgical reimplantation effectively managed the anomalous coronary artery, alleviating arrhythmia burden.
• This case highlights the importance of advanced imaging in diagnosing rare coronary anomalies.
• The successful outcome suggests surgical correction is a viable therapeutic option for symptomatic patients with this rare anomaly.