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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 aortic origin of the left main coronary artery associated with arterial compression-Case report

Davi F Tenório1, Leonardo A Miana1, Antonio C de Almeida Barbosa Filho2

  • 1Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, São Paulo, Brazil.

Journal of Cardiac Surgery
|April 19, 2021
PubMed

Insights

Anomalous aortic origin of the coronary artery is a rare condition. Surgical correction in a pediatric patient successfully resolved symptoms of shortness of breath and angina.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Pediatric Cardiac Surgery

Background:

  • Anomalous aortic origin of the coronary artery (AAOCA) is a rare congenital anomaly.
  • It presents with diverse symptoms, often exercise-induced, including chest pain and syncope.
  • Advances in cardiac imaging facilitate earlier diagnosis and management.

Observation:

  • An 11-year-old female presented with exertional dyspnea, angina, and syncope.
  • Holter monitoring revealed nonsustained ventricular tachycardia.
  • Coronary angiotomography identified anomalous origin of the left coronary artery from the right aortic cusp with significant external compression.

Findings:

  • Surgical correction involved dissecting the left coronary artery, performing coronary arteriotomy, roof ampliation with autologous pericardium, and creating a neo-ostium.
  • The patient experienced a satisfactory postoperative recovery.
  • The patient remained asymptomatic at 14 months follow-up.

Implications:

  • This case highlights successful surgical management of AAOCA in a pediatric patient.
  • Early diagnosis and intervention are crucial for favorable outcomes.
  • Surgical techniques can effectively restore coronary artery anatomy and alleviate symptoms.
Abstract

Keywords:
anomalous aortic origin of coronary arteryanomalous aortic origin of left coronary arteryanomalous origin of a coronary artery from the opposite sinuscongenital heart diseasecongenital heart surgerycoronary artery anomaly

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