Introduction: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease that usually presents with heart failure symptoms in infants. Without surgical correction, the condition has a high infant mortality rate. However, patients with ALCAPA can remain asymptomatic for decades in some cases, and the risk of sudden death decreases in adulthood.
Presentation Of Case: We present the case of a 52-year-old female who was incidentally diagnosed with ALCAPA during a routine medical evaluation. As the patient age, was asymptomatic, had good coronary collateral circulation, a medical treatment strategy was chosen and the patient was discharged in a good physical condition. And during the three-month follow-up, no cardiovascular complications were observed.
Discussion: The appearance and severity of symptoms in patients with ALCAPA can vary depending on factors such as the closure of the patent ductus arteriosus (PDA), pressure gradient between arteries, collateral development, and coronary anatomy. Surgical intervention is typically recommended, but in select cases such us, conservative management may be considered for elderly patients due to increased surgical risks and potentially lower risk of sudden cardiac death. Individualized patient assessment is crucial in determining the optimal treatment strategy for ALCAPA, considering the available evidence and limitations.
Conclusion: The management of asymptomatic patients with ALCAPA remains a subject of discussion, and further research is needed to standardize the clinical approach for this subgroup of patients and to compare survival rates between surgical correction and medical therapy.
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http://dx.doi.org/10.1016/j.ijscr.2023.108521 | DOI Listing |
Eur Heart J Case Rep
January 2025
Cardiology Department, Meir Medical Center, Tchernichovsky St 59, Kfar Saba 4418001, Israel.
Background: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA) (ALCAPA) is a rare congenital abnormality. We present a case of an ALCAPA in a 25-year-old man.
Case Summary: A 25-year-old male with no past medical history was admitted to our intensive cardiac care unit after sudden cardiac arrest due to ventricular fibrillation and suspected acute coronary syndrome.
Radiol Cardiothorac Imaging
February 2025
From the Department of Radiology, Narayana Institute of Cardiac Sciences, Bangalore 560099, India (S.G., V.R.); and Department of Radiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India (R.R.).
Pediatr Cardiol
December 2024
Pediatric Cardiac Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
The present study is the first meta-analysis comparing long-term outcomes in patients undergoing correction for anomalous left coronary artery (ALCAPA) regarding concomitant mitral valve surgery. A systematic literature review was conducted to identify all relevant studies with comparative data on mitral valve surgery performed during surgery for ALCAPA correction. Predefined primary end points included mortality and mitral valve (re)operation.
View Article and Find Full Text PDFIndian J Thorac Cardiovasc Surg
January 2025
Department of Cardiovascular & Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Asarwa, Ahmedabad, 380016 Gujarat India.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. It presents as myocardial infarction in children; however, the presentation may vary between asymptomatic to progressive heart failure and also death. As a result, diagnosis in living adults is extremely rare.
View Article and Find Full Text PDFRadiol Case Rep
January 2025
Head of Department of Cardiology, Al Bassel Heart Institute, Damascus, Syria.
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital deformity, and its association with truncus arteriosus (TA) has been infrequently described in medical literature. We report a case of a 3-year-old child presenting with failure to thrive and recurrent respiratory infections, who was diagnosed with truncus arteriosus type 1 and an anomalous left coronary artery originating from the pulmonary artery. The embryological basis of both TA and ALCAPA involves disruptions in the normal development of the aorticopulmonary septum and coronary arteries.
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