Skip to main content
Log in

A review of 15-year experience with anomalous origin of the left coronary artery

  • Original Article
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare condition presenting in infancy with acute myocardial ischaemia.

Aims

A retrospective study was undertaken to assess the presenting features and long-term outcome of all cases of ALCAPA presenting to our institution over a 15-year period.

Methods

All the cases were located using the hospital discharge system and charts were reviewed.

Results

The mean age at diagnosis was 4.5 months (2 weeks to 16 months). The predominant presenting symptoms were irritability, pallor, and tachypnoea. The predominant electrocardiogram findings were Q waves and ST segment changes in the anterolateral chest leads. One died from the 11 patients in our series.

Conclusion

The outcome for surgical re-implantation in infants with a diagnosis of ALCAPA is very good however, early diagnosis is crucial to survival. Although once successfully repaired, patients in general were free of symptoms, ventricular dysfunction was usually present, requiring long-term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Keith JD (1959) The anomalous origin of the left coronary artery from the pulmonary artery. Br Heart J 21:149–161

    Article  PubMed  CAS  Google Scholar 

  2. Wessselhoeft H, Fawcett JS, Johnson AL (1968) Anomalous origin of the left coronary artery from the pulmonary trunk. Circulation 38:403–425

    Google Scholar 

  3. Neches WH, Mathews RA, Park SC et al (1974) Anomalous origin of the left coronary artery from the pulmonary artery. Circulation 50:582–587

    PubMed  CAS  Google Scholar 

  4. Edwards JE (1964) The direction of blood flow in coronary arteries arising from the pulmonary trunk. Circulation 29:163–166

    PubMed  CAS  Google Scholar 

  5. Driscoll DJ, Nihill MR, Mullins CE, Cooley DA, McNamarra DG (1981) Management of symptomatic infants with anomalous origin of the left coronary artery from the pulmonary artery. Am J Cardiol 47:642–648

    Article  PubMed  CAS  Google Scholar 

  6. Silverman NH (1993) Paediatric echocardiography. Williams and Wilkins, Baltimore, p 628

    Google Scholar 

  7. Bland EF, White PD, Garland J (1933) Congenital anomalies of the coronary arteries. Am Heart J 8:787–797

    Article  Google Scholar 

  8. Grace RR, Angeleni P, Cooley DA (1977) Aortic implantation of anomalous left coronary artery arising from the pulmonary trunk. Am J Cardiol 39:608–613

    Article  Google Scholar 

  9. Laborbe F, Marchland M, Leca F, Jarreau M, Dequirot A, Hazan E (1981) Surgical treatment of anomalous origin of the left coronary artery in infancy and childhood. J Thorac Cardiovasc Surg 82:423–428

    Google Scholar 

  10. Takeuchi S, Imamura H, Katsumoto K et al (1981) New surgical method for repair of anomalous left coronary artery from the pulmonary artery. J Thorac Cardiovasc Surg 82 423–428

    Google Scholar 

  11. Cochrane A, Coleman D, Davis A, Brizard C, Wolfe R, Karl T (1999) Excellent long-term functional outcome after an operation for anomalous left coronary artery from the pulmonary artery. J Thorac Cardiovasc Surg 117(2):332–342

    Article  PubMed  CAS  Google Scholar 

  12. Rein AJJT, Colan SD, Parness IA, Sanders SP (1987) Regional and global left ventricular function in infants with anomalous coronary artery from the coronary trunk :preoperative and postoperative assessment. Circulation 75:115–123

    PubMed  CAS  Google Scholar 

  13. Schwartz ML, Jonas RA, Colan SD (1997) Anomalous origin of the left coronary artery from pulmonary artery: recovery of left ventricular function after dual coronary repair. J Am Coll Cardiol 30:547–553

    Article  PubMed  CAS  Google Scholar 

  14. Turley K, Szarnicki RJ, Flachsbart KD, Richter RC, Popper RW, Tarnoff H (1995) Aortic implantation is possible in all cases of anomalousorigin of the left coronary artery from the pulmonary artery. Ann Thorac Surg 60:84–89

    PubMed  CAS  Google Scholar 

  15. Terai M, Nagai Y, Toba T (1983) Cross-sectional echocardiographic findings of left coronary artery from the pulmonary artery. Br Heart J 50:104–105

    Article  PubMed  CAS  Google Scholar 

  16. Karl TR, Sano S, Horton S, Mee RBB (1989) Centrifugal left heart assist in cardiac operations. J Thorac Cardiovasc Surg 98:16–24

    Google Scholar 

  17. Vouhe PR, Baillot-Vernant F, Trinquet F et al (1987) Anomalous left coronary artery from the pulmonary artery in infants: which operation ? When ? J Thorac Cardiovasc Surg 94:192–199

    PubMed  CAS  Google Scholar 

  18. Colan SD, Parness IA, Spevak PJ, Sanders SP (1992) Developmental modulation of myocardial mechanics:age and growth related alterations in afterload and contractility. J Am Coll Cardiol 19:619–629

    Article  PubMed  CAS  Google Scholar 

  19. Arciniegas E,Farooki ZQ, Hakimi M, Green EW (1980) Management of anomalous left coronary artery from the pulmonary artery. Circulation 62:180–189

    Google Scholar 

  20. Vigneswaran WT, Campbell DN, Pappas G, Wiggins JW, Wolfe RW, Clarke DR (1989) Evolution of the management of anomalous left coronary artery: a new surgical approach. Ann Throac Surg 48(4):560–564

    CAS  Google Scholar 

  21. Backer CL, Stout MJ, Zales VR et al (1992) Anomalous origin of the left coronary artery: a twenty year review of surgical management. J Thorac Cardiovasc Surg 103:1049–1058

    PubMed  CAS  Google Scholar 

  22. McNamara DG, El-Said G (1973) Treatment of anomalous origin of the left coronary artery from the pulmonary artery. Eur J Cardiol 1:497–499

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. A. Walsh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Walsh, M.A., Duff, D., Oslizlok, P. et al. A review of 15-year experience with anomalous origin of the left coronary artery . Ir J Med Sci 177, 127–130 (2008). https://doi.org/10.1007/s11845-008-0146-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-008-0146-y

Keywords

Navigation