Coronary Artery Origin Anomalies with Especial Emphasis on Delayed Diagnosis of Anomalous Origin of the Left Coronary Artery from Pulmonary Artery, A report from South of Iran

Ahmad Amirghofran; GH  Ajami; Mohammad  Borzouee; MA  Navvabi; Hamid  Amoozgar; S  Sarikhani

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Coronary Artery Origin Anomalies with Especial Emphasis on Delayed Diagnosis of Anomalous Origin of the Left Coronary Artery from Pulmonary Artery, A report from South of Iran

Author(s):

Ahmad Amirghofran¹,

GH Ajami¹,

Mohammad Borzouee¹,

MA Navvabi¹,

Hamid Amoozgar ^1,*,

S Sarikhani¹

1Cardiovascular Research Center, , Shiraz University of Medical Sciences, Shiraz, Iran

International Cardiovascular Research Journal:Vol. 3, issue 1; e68528

Published online:Mar 31, 2009

Article type:Brief Report

Received:Mar 11, 2018

Accepted:Mar 31, 2009

How to Cite:Amirghofran A, Ajami G, Borzouee M, Navvabi M, Amoozgar H, et al. Coronary Artery Origin Anomalies with Especial Emphasis on Delayed Diagnosis of Anomalous Origin of the Left Coronary Artery from Pulmonary Artery, A report from South of Iran.Int Cardiovasc Res J.2009;3(1):e68528.

Abstract

Background: The aim of this study was to determine the clinical course and outcome of coronary artery anomalies including anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) diagnosed by coronary artery angiography (CAA) at our institution. The term coronary artery anomaly refers to a wide range of congenital abnormalities, involving the origin, course and the structure of epicardial coronary arteries. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, but potentially fatal congenital coronary anomaly.
Patients and Methods: The review included 21280 patients undergoing CAA at Medical Centers of Shiraz University between years 1997 -2006. The hospital records of all patients with diagnosis of ALCAPA reviewed for analysis. Data were expressed as percentages.
Results: There were 149 (0.7 %) cases of coronary anomalies, including 9 (6.04%) proven cases of ALCAPA. In ALCAPA group ,five patients presented with congestive heart failure (CHF) and a non-specific systolic murmur on examination. Isolated mitral valve regurgitation (MR), cerebrovascular accident due to embolization of a mural thrombus, and chest pain were the main presentations in three patients. Two of the patients were under follow up with presumptive diagnosis of coronary artery fistula. The patients aged between 4 months and 35 years. Surgical correction done for all the patients with ALCAPA by direct reimplantation in 8 patients and Takeuchi technique in one. We had one early hospital mortality in our group.
Conclusion: ALCAPA should be considered in differential diagnosis of any patient presenting with dilated cardiomyopathy, CHF, MR or chest pain syndrome. Awareness of such pathology can prevent or decrease the morbidity and mortality of a potentially fatal congenital heart disease.

Keywords

Coronary Artery Anomalies

ALCAPA

Delayed Diagnosis

Reimplantaion

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