Abstract

  Anomalous of the Left Coronary Artery Originating from the Pulmonary Artery (ALCAPA) is a rare congenital heart disease. The onset time and severity of clinical symptoms of ALCAPA were determined by the rate of pulmonary artery pressure decline, the opening of collateral circulation, and the stenosis of the opening of the left coronary artery at the origin of ectopic location. If there is little or no collateral circulation between the coronary arteries, symptoms of myocardial ischemia and heart failure may occur early in the child. If abundant collateral circulation is formed between the left coronary artery of ectopic origin and the right coronary artery of normal position, the left coronary artery can maintain enough blood perfusion, and the symptoms will appear later. But "steal phenomenon" in the left coronary artery, can also cause hypoxia and ischemia of the myocardium, leading to significant cardiac enlargement and mitral regurgitation. Early diagnoisis and surgical treatment can significantly improve the prognosis of ALCAPA. We also conducted a retrospective case of a child with ALCAPA, to better understand the pathophysiology.

Keywords: Pulmonary Artery; Children; Congenital Heart Disease; ALCAPA

References

1. Dodge-Khatami A., et al. “Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Collective Review of Surgical Therapy”. The Annals of Thoracic Surgery 74.3 (2002): 946-955.
2. Neches WH., et al. “Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: A New Method of Surgical Repair”. Circulation 50.3 (1974): 582-587.
3. Wu Q and Xu Z. “An Alternative Procedure for Correction of Anomalous Origin of Left Coronary Artery from the Pulmonary Artery”. The Annals of Thoracic Surgery 84.6 (2007): 2132-2133.
4. Cabrera AG., et al. “Outcomes of Anomalous Left Coronary Artery from Pulmonary Artery Repair: Beyond Normal Function”. The Annals of Thoracic Surgery 99.4 (2015): 1342-1347.
5. Jian G and Qi L. “Diagnosis and Treatment of Left Coronary Artery Ectopia Originating from Pulmonary Artery”. Er Ke Da Cha Fang 4.3 (2015): 130-137. 
6. Wesselhoeft H., et al. “Anomalous Origin of the Left Coronary Artery from the Pulmonary Trunk: Its Clinical Spectrum, Pathology, and Pathophysiology, based on A Review of 140 Cases with Seven Further Cases”. Circulation 38.2 (1968): 403-425.
7. Lange R., et al. “Long-Term Results of Repair of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery”. The Annals of Thoracic Surgery 83.4 (2007): 1463-1471.
8. Wesselhoeft H., et al. “Anomalous Origin of the Left Coronary Artery from the Pulmonary Trunk: Its Clinical Spectrum, Pathology, and Pathophysiology, based on A Review of 140 Cases with Seven Further Cases”. Circulation 38.2 (1968): 403-425.
9. Boutsikou M., et al. “Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) Diagnosed in Adulthood: Varied Clinical Presentation, Therapeutic Approach and Outcome”. International Journal of Cardiology 261 (2018): 49-53.
10. Wolf D., et al. “Major Coronary Anomalies in Childhood”. European Journal of Pediatrics 161.12 (2002): 637-642.
11. Wu LJ., et al. “The Diagnostic Value and Analysis of Misdiagnosis of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery by Doppler Echocardiography”. Journal of Medical Imaging 20.12 (2010): 1788-1790.
12. Xu G., et al. “Evaluation of Myocardial Viability in Pediatric Patients with Anomalous Origin of Left Coronary Artery from Pulmonary Artery by 18F-Flurodeoxyglucose Myocardial Imaging”. Chinese Circulation Journal 25.5 (2010): 371-374.
13. Schwartz ML., et al. “Anomalous Origin of Left Coronary Artery from Pulmonary Artery: Recovery of Left Ventricular Function after Dual Coronary Repair”. Journal of the American College of Cardiology 30.2 (1997): 547-553.
14. Qiu J., et al. “Repair of Anomalous Coronary Artery from the Pulmonary Artery: A-Signal Center 20-Year Experience”. International Journal of Cardiology 223 (2016): 625-629.
15. Neumann A., et al. “Long-Term Results after Repair of Anomalous Origin of Left Coronary Artery from the Pulmonary Artery: Takeuchi Repair Versus Coronary Transfer”. European Journal of Cardio-Thoracic Surgery 51.2 (2017): 308-315.

Citation

Citation: Juan Du and Cong Chen. “Anomalous of the Left Coronary Artery Originating from the Pulmonary Artery in Children - A Mini Review and a Case Report”. Acta Scientific Paediatrics 3.3 (2020): 13-16.

Copyright

Copyright: © 2020 Juan Du and Cong Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.