Reconstruction of anomalous left coronary artery from pulmonary artery in an adult patient: a case report

J Cardiothorac Surg. 2019 Feb 26;14(1):40. doi: 10.1186/s13019-019-0866-2.

Abstract

Background: Anomalous left coronary artery from the pulmonary artery is a congenital heart disease in which myocardial ischemia occurs within 1 year of birth. Adults have been reported to survive owing to the development of collateral perfusion from right coronary artery. In these cases, however, revascularization is necessary to prevent sudden cardiac death.

Case presentation: A 62-year-old female gradually started experiencing dyspnea during exercise. Coronary computed tomography revealed that the left coronary artery arose from the main pulmonary artery. The patient was subsequently diagnosed with adult-type, anomalous left coronary artery from the pulmonary artery. She underwent a surgery, in which a 6-mm vascular prosthesis was passed through the main pulmonary artery to anastomose the left coronary artery and ascending aorta.

Conclusion: Our reconstructive technique using vascular prosthesis is effective for anomalous left coronary artery from pulmonary artery in adults.

Keywords: ALCAPA; Adult congenital heart disease; Coronary artery; Vascular prosthesis.

Publication types

  • Case Reports

MeSH terms

  • Anastomosis, Surgical
  • Aorta / diagnostic imaging
  • Aorta / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Coronary Vessel Anomalies / diagnostic imaging
  • Coronary Vessel Anomalies / surgery*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery*
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Dyspnea / etiology
  • Female
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / surgery*
  • Humans
  • Middle Aged
  • Myocardial Ischemia / etiology
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / surgery*
  • Tomography, X-Ray Computed