Turk Kardiyol Dern Ars. 2012; 40(1): 48-51 | DOI: 10.5543/tkda.2012.01605

Two adult cases of anomalous left coronary artery from the pulmonary artery

Ahmet Çağrı Aykan, Mustafa Yıldız, Gökhan Kahveci, Mehmet Özkan
Department of Cardiology, Kartal Kosuyolu Heart Training And Research Hospital, Istanbul, Turkey

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that presents as left-sided heart failure and mitral valve insufficiency during the first months of life. However, some cases may benefit from sufficient collateral blood supply from the right coronary artery, resulting in increased survival even to advanced ages. Herein, we report on two adult cases of ALCAPA, namely, a 52-year-old male patient that presented with angina and a 70-year-old female patient presenting with stroke, dyspnea, and pretibial edema. In both cases, ALCAPA was demonstrated by coronary angiography and multislice computed tomography angiography. The younger patient refused surgery and remained asymptomatic and event-free during a two-year follow-up with anti-ischemic medications, while the older with high surgical risk was considered for intracardiac defibrillator implantation along with medical therapy.

Keywords: Adult, coronary angiography, coronary vessel anomalies, echocardiography; pulmonary artery/abnormalities; syndrome; tomography, X-ray computed

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