Cardiovascular Pharmacology: Open Access

Benign presentation of a potentially fatal disease

11^th World Congress on Pediatric Cardiology and Congenital Cardiovascular Disease

April 18-19, 2017 London, UK

Sara Ranchordas, Marcio Madeira, Duarte Saraiva Martins, Marta Marques, Antonio Ferreira, Isabel Menezes, Rui Anjos and Miguel Abecasis

Santa Cruz Hospital, Portugal

Posters & Accepted Abstracts: Cardiovasc Pharm

Abstract:

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.

Biography :

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