Sara Ranchordas, Marcio Madeira, Duarte Saraiva Martins, Marta Marques, Antonio Ferreira, Isabel Menezes, Rui Anjos and Miguel Abecasis
Santa Cruz Hospital, Portugal
Scientific Tracks Abstracts: Cardiovasc Pharm
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiovascular defect that can range from being fatal early in life to presenting in adulthood asymptomatically. We present the case of a teenager whose diagnosis was incidental during examination for sports practice. The echocardiogram raised the suspicion of an anomalous flow in the coronary arteries and showed mitral valve prolapse with mild regurgitation. Magnetic resonance imaging revealed a very ectasia right coronary artery and low signal intensity in the usual location of the left anterior descending artery. The diagnostic hallmark of ALCAPA syndrome is the visualization of the left coronary artery originating from the main pulmonary artery, which was only possible in this case with coronary angiography, that showed an aneurismatic right coronary artery with retrograde filling from the left coronary artery, ending in the pulmonary artery and multiple vascular connections between the right and left coronary system. Surgical techniques can be broadly divided into one-coronary and two-coronary-system repairs. Surgery allows correction of chronic subendocardial ischemia, improvement of ventricular function, and minimizes the risk for malignant dysrhythmias and sudden death. Two-coronary-system repairs are preferred and include coronary button transfer, the Takeuchi procedure, or placement of a coronary artery bypass graft with ligation of the origin of the left coronary artery. This patient was submitted to coronary artery button transfer with excellent result.
Sara Ranchordas has completed her Medical degree in Porto University Medical Faculty in 2012 and is a Cardiac Surgery Resident in Santa Cruz Hospital, Lisbon, since 2014. She has been working with a team of congenital heart disease surgeons, having participated in diverse pediatric surgeries. She has presented poster and oral presentations in national conferences and published case reports in the area of Cardiology and Cardiac Surgery.
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