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Daniele Maselli
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J Thorac Cardiovasc Surg 2007;134:518-520
© 2007 The American Association for Thoracic Surgery

Brief Communication

Anomalous origin of the left main artery from the pulmonary artery: Adult presentation with systemic collateral supply and giant right coronary artery aneurysm

Pietro Bajona, MDa,*, Daniele Maselli, MDa, Roberto Dore, MDb, Gaetano Minzioni, MDa

a Cardiothoracic Department, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
b Department of Radiology, University Hospital of Pavia, Pavia, Italy.

Received for publication March 26, 2007; accepted for publication April 20, 2007.

* Address for reprints: Pietro Bajona, MD, Cardiothoracic Department, Azienda Ospedaliera Universitaria Pisana, Via Paradisa 2, 56124 Pisa, Italy. (Email: pietro.bajona@libero.it).

The first 20% of the full text of this article appears below.


Figure 1
Dr Bajona


Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) in adulthood is rare, and clinical presentation depends on collateral circulation between and to the coronary arteries. We present an adult patient with ALCAPA with systemic collateral supply to the LCA and a giant right coronary artery (RCA) aneurysm who was successfully treated by means of closure of the anomalous origin of the left main artery and repair of the aneurysm.

Clinical Summary

A 44-year-old male physician was referred to our hospital because of a 6–month history of dizziness and increasing dyspnea on exertion. He had been a rugby player since childhood and had played semiprofessionally until a year before. He smoked 10 cigarettes per day, and he had no other risk factors for coronary artery disease. The results of physical examination were normal. Blood pressure was within normal limits. Laboratory test results were normal. Chest radiography revealed the presence of a moderate cardiomegaly and opacity overlapping the right heart border and the right pulmonary hilum. Electrocardiography revealed sinus rhythm and left ventricular hypertrophy with normal patterns . . . [Full Text of this Article]






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