Anomalous origin of the left coronary artery from the right pulmonary artery with intramural aortic trajectory. Clinicosurgical diagnostic implications
| Autor: | L J Kajita, Adib D Jatene, Edmar Atik, Munir Ebaid, Miguel Barbero-Marcial, Carla Tanamati |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Adolescent Coronary Vessel Anomalies Aorta Thoracic Anastomosis Pulmonary Artery anomalous origin of the left coronary artery Angina Left coronary artery Internal medicine medicine.artery Medicine Humans Myocardial infarction Child right pulmonary artery Mitral regurgitation business.industry medicine.disease Right pulmonary artery medicine.anatomical_structure lcsh:RC666-701 Heart failure Child Preschool Cardiology Female Radiology Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Arquivos Brasileiros de Cardiologia, Vol 73, Iss 2, Pp 181-190 (1999) Arquivos Brasileiros de Cardiologia, Volume: 73, Issue: 2, Pages: 181-190, Published: AUG 1999 Arquivos Brasileiros de Cardiologia v.73 n.2 1999 Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
| ISSN: | 1678-4170 |
| Popis: | OBJECTIVE: Anomalous origin of the left coronary artery from the right pulmonary artery (AOLCARPA), is a rare entity that is usually associated with other defects. Of the 20 cases of AOLCARPA reported in the literature, 14 (70%) had associations. We describe four patients with AOLCARPA without associated defects, but with a peculiar intramural aortic trajectory. METHODS: Fifty-five patients with anomalous origin of the left coronary artery were operated upon at INCOR-FMUSP. Four of the patients had the anomalous origin from the right pulmonary artery (RPA) without associated defects but with intramural aortic trajectory. Clinical and laboratory examinations were analyzed, as well as surgical findings. RESULTS: All patients had congestive heart failure (CHF) and 3 also had angina pectoris. Two patients had a murmur of mitral regurgitation, signs of myocardial infarction on the ECG and cardiomegaly. The shortening fraction varied from 9% to 23%. The hemodynamic study confirmed the diagnosis of anomalous origin of the coronary artery, but the intramural trajectory and the origin from the RPA were established only at surgery. In 3 patients, the technique of side-to-side anastomosis was performed with a good outcome. One patient, who underwent end-to-side anastomosis, died 6 months after the surgery. CONCLUSION: Association with other defects usually occurs in the AOLCARPA, and the intramural aortic trajectory is difficult to clinically diagnose but easy to surgically correct. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|