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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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[Abnormal aortic origin of coronary arteries]

Juan M Bonelli1, Ana M Schroh2, Alejandro Peirone3

  • 1Servicio de Tomografía Axial Computarizada, Fundación Escuela de Medicina Nuclear (FUESMEN), Mendoza, Argentina.

Archivos De Cardiologia De Mexico
|September 5, 2023
PubMed

Insights

Anomalous aortic origin of coronary arteries is rare but can cause sudden death or complications during cardiac procedures. Early detection through imaging techniques like echocardiography and CT angiography is crucial for patient management.

Area of Science:

  • Cardiovascular Imaging
  • Congenital Heart Disease
  • Interventional Cardiology

Context:

  • Anomalous aortic origin of the coronary arteries (AAOCA) affects 0.02-5.7% of the population.
  • AAOCA can lead to sudden cardiac death, especially with interarterial or intramural pathways.
  • These anomalies pose risks during interventions on cardiac structures.

Purpose:

  • To identify patients with anomalous aortic origin of coronary arteries using imaging modalities.
  • To evaluate the effectiveness of transthoracic color Doppler echocardiography (TTE), CT multislice angiography, and coronary angiography in detecting AAOCA.

Summary:

  • Fifteen patients with AAOCA were identified.
  • Transthoracic color Doppler echocardiography (TTE) raised suspicion in 12 patients; CT multislice angiography was diagnostic in 3.
  • The circumflex artery was most frequently involved (12/15), with other cases involving right and anterior descending coronary arteries with interarterial courses.

Impact:

  • Underdiagnosis of AAOCA by TTE can occur due to visualization challenges, particularly with age.
  • Accurate detection of AAOCA is vital for preventing sudden death.
  • Identifying AAOCA is critical for mitigating complications during interventional procedures.
Abstract

Keywords:
Congenital heart diseaseCoronary abnormalitiesTransthoracic echocardiography

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