Pulmonary artery “stop-flow” angiography to visualize the anomalous origin of the left coronary artery from the pulmonary artery in infants
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In five infants, anomalous left coronary from the pulmonary artery (ALCA) was diagnosed by selective pulmonary artery angiography using the “stop flow” technique: the left pulmonary artery was occluded by inflating a balloon and a large bolus of dye was injected proximal to the balloon at a high flow velocity. These conditions, by increasing pulmonary artery pressure, increase the chances of imaging directly an ALCA. It also leaves the left pulmonary artery branches free of contrast medium and allows easier visualization of ALCA, mainly in the antero-posterior view. When an ALCA is injected from the pulmonary artery, left heart catheterization can be avoided. However, a false-negative result is to be expected in specific conditions and was observed in one of our patients. If pulmonary angiography fails to prove a ALCA, left heart catheterization remains mandatory to exclude the diagnosis.
Key wordsAnomalous left coronary artery Pulmonary artery angiography
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- 1.Armer RM, Shumacker HB, Lurie PR, Fisch C (1963) Origin of the left coronary artery from the pulmonary artery without collateral circulation: report of a case with a suggested surgical correction.Pediatrics 32:588–593Google Scholar
- 2.Askenzai J, Nadas AS (1975) Anomalous left coronary artery originating from the pulmonary artery: report of 15 cases.Circulation 51:976–987Google Scholar
- 3.Fischer EA, Sepehri B, Lendrum B, Luken J, Levitsky S (1981) Two-dimensional echocardiography visualization of the left coronary artery from the pulmonary artery: pre- and post-operative studies.Circulation 63:698–704Google Scholar
- 4.Kachaner J, Piéchaud JF, Batisse A, Fermont L (1980) l'Angiocardiographie pédiatrique par double arceau à déplacements simultanés aléatoires compatibles.Coeur 11:1013–1023Google Scholar
- 7.Talner NS, Stern AM, Figley MM (1960) Angiocardiographic diagnosis of an anomalous left coronary artery originating from the pulmonary artery.Am J Cardiol 6:694–700Google Scholar
- 8.Terai M, Nagai Y, Toba T (1983) Cross-sectional echocardiographic findings of anomalous origin of left coronary artery from the pulmonary artery.Am J Cardiol 6:694–700Google Scholar