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Edmund Kenneth Kerut MD Philip G. Kogos MD Jason H. Anderson MD Michael Turner MD Robert Ascuitto MD Nancy Ross‐Ascuitto MD Sameh M. Said MD 《Echocardiography (Mount Kisco, N.Y.)》2018,35(7):1045-1048
A healthy 20‐year‐old male presented with aborted sudden death. Both thoracic echocardiography and cardiac computed tomographic angiography demonstrated the characteristic findings of ALCAPA noting a dilated and tortuous right coronary artery, dilated coronary collateral arteries within the interventricular septum or along the surface of the heart, and visualization of the left coronary artery origin from the posterior aspect of the main pulmonary artery. Both imaging modalities demonstrated all three characteristic findings of this rare coronary anomaly and served as complementary imaging studies for surgical correction. 相似文献
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KECECIOGLU D.; KOTTHOFF S.; KONERTZ W.; SCHELD H. H.; VOGT J. 《European heart journal》1993,14(7):1006-1007
In two infants the anomalous origin of the left coronary arteryfrom the pulmonary artery (ALCAPA) was detected prospectivelyby transoesophageal echocardiography (TEE). Colour flow mappingand pulsed Doppler ultrasound revealed a predominant right-to-leftshunt from the pulmonary artery to the left coronary artery.These findings were confirmed by angiography. Transihoracic echocardiography (TTE)failed to show the anomalousorigin of the left coronary artery or any abnormal pulmonaryflow pattern. TEE may be useful in the diagnosis of ALCAPA in selected cases,when TTE is inconclusive. 相似文献
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Coronary artery bypass grafting in infants,children, and young adults for acquired and congenital lesions
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Constantine Mavroudis MD 《Congenital heart disease》2017,12(5):644-646
Coronary artery disease ranges from congenital in origin such as anomalous aortic origin of a coronary artery (AAOCA) to acquired diseases such as Kawasaki disease, and previously repaired conditions such as transposition of the great arteries. It is not uncommon, in the long run, for proximal coronary stenosis to develop following arterial switch, AAOCA repair, Ross procedure and Kawasaki disease leading to coronary artery bypass grafing (CABG). The objective of this report is to discuss the indications, challenges, and outcomes of CABG in infants, children, and young adults with acquired and congenital lesions. 相似文献
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Kanwal M. Farooqi MD Nicole Sutton MD Samuel Weinstein MD Mark Menegus MD Hugo Spindola‐Franco MD Robert H. Pass MD 《Congenital heart disease》2012,7(6):E97-E102
Myocardial infarction in a neonate is rare. We describe the case of a full‐term male who presented with respiratory distress. A chest radiograph demonstrated cardiomegaly. An electrocardiogram revealed ST segment changes suggestive of ischemia. Cardiac enzymes were elevated and an echocardiogram revealed a regional wall motion abnormality. Cardiac catheterization was performed demonstrating occlusion of the ramus intermedius branch of the left main coronary artery. The patient decompensated, requiring extracorporeal membrane oxygenation (ECMO). The infant was able to be decannulated from ECMO support in 5 days and was ultimately discharged on hospital day 25. We review this case as well as the literature on neonatal myocardial infarction. 相似文献
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Walsh MA Duff D Oslizlok P Redmond M Walsh KP Wood AE Coleman DM 《Irish journal of medical science》2008,177(2):127-130
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. 相似文献
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Amer Harky Arish Noshirwani Ozhin Karadakhy Juliana Ang 《Journal of cardiac surgery》2019,34(11):1328-1343
Coronary artery anomalies (CAA) are vanishingly rare, affecting less than 1% of the general population. While the majority of anomalies do not cause significant symptoms; those that do, have devastating outcomes on the patient. Seventeen percent of deaths from exercise is attributed to CAA, and over half of these present as sudden death making CAA the second most common cause of sudden cardiac death in individuals. Computed tomography is generally regarded as the first‐line investigation due to its superior ability to delineate the course of the coronary vessels and the surrounding structures, while intravascular coronary angiography can be helpful in assessing the vessels if there is evidence of stenosis. A multidisciplinary approach is adopted with patient expectations at the core of the management. Once the decision to operate has been made, there are multiple techniques available to the surgeon for the management of anomalous vessels. Surgical repair forms the key management step in such patients. Currently, surgery in elective cases is associated with extremely low morbidity and mortality and it is considered a safe option with a fantastic long‐term prognosis. The ideal approach for assessment and risk stratification remains uncertain, and the inherent variability of coronary anomalies and patient factors demands a multidisciplinary team with an individualized approach. 相似文献
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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare condition. The majority of cases
present with impaired left ventricular function. We report on a premature infant who was diagnosed at a gestational age near
term with ALCAPA during routine cardiac examination. The patient showed no signs of myocardial ischemia and is doing well
after corrective surgery. This is the youngest patient reported with ALCAPA and preserved myocardial function. 相似文献