Dipyridamole Tl-201 myocardial single photon emission computed tomography in the functional assessment of anomalous left coronary artery from the pulmonary artery

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital heart disease. Without surgical correction, most patients with this anomaly die during infancy from myocardial infarction and heart failure, with a mortality rate reported to be greater than 90% by 1 year of age. Some patients with significant collateral circulation from the right coronary artery may remain asymptomatic and survive into adulthood, but they usually develop progressive left ventricular dysfunction. The detection of myocardial ischemia in these patients is important to identify viable myocardium at risk for irreversible damage. We present 1 such case in which dipyridamole Tl-201 SPECT myocardial perfusion imaging played an important role in the decision-making process and was shown to be useful for the evaluation of the surgical result.