Journal of Cardiothoracic Surgery (Jan 2013)

A rare case of anomalous origin of the left main coronary artery in an adult patient

  • Dionne Pierre O,
  • Poirier Nancy,
  • Forcillo Jessica,
  • Stevens Louis M,
  • Chartrand-Lefebvre Carl,
  • Mansour Samer,
  • Noiseux Nicolas

DOI
https://doi.org/10.1186/1749-8090-8-15
Journal volume & issue
Vol. 8, no. 1
p. 15

Abstract

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Abstract Anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that causes a left-to-right shunt via the coronary system, resulting in coronary steal. We report an unusual case of a healthy 48 years-old patient presenting with dyspnea on exertion and mild chest pain who underwent surgical correction of this rare anomaly. Multiple procedures have been proposed in adults with ALCAPA. Although re-implantation of the left main coronary artery (LMCA) to the aorta remains the most physiological correction for this anomaly, the combination of LMCA ligation and coronary artery bypass grafting provides a dual coronary flow system and is preferable when re-implantation is impossible.

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