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Francois Lacour-Gayet
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J Thorac Cardiovasc Surg 2008;135:696-698
© 2008 The American Association for Thoracic Surgery

Brief Communication

Anomalous left coronary artery from the pulmonary artery with an intramural course within the aortic wall: Report of 3 surgical cases

Steven P. Goldberg, MDa, Max B. Mitchell, MDa,*, David N. Campbell, MDa, Cecile Tissot, MDb, Francois Lacour-Gayet, MDa

a Division of Cardiothoracic Surgery, The Children's Hospital, Denver, Colo
b Division of Pediatric Cardiology, The Children's Hospital, Denver, Colo

Received for publication September 27, 2007; accepted for publication October 15, 2007.

* Address for reprints: Max B. Mitchell, MD, The Children's Hospital, Denver, Division of Cardiothoracic Surgery, 13123 East 16th Avenue, Box B200, Aurora, Colorado 80045. (Email: Mitchell.Max@tchden.org).

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

Since 1996, we have operated on 15 patients with anomalous left coronary artery from the pulmonary artery (ALCAPA). Three cases involved a rare variant in which the left coronary artery (LCA) also took an intramural aortic course in the left sinus of Valsalva (LSV) and then exited the aorta to assume its usual pattern.

Clinical Summary

Patient 1
A 3-month-old infant underwent an emergency operation for ALCAPA. The LSV was unusually adherent to the adjacent pulmonary artery. The LCA originated from the inferior proximal right pulmonary artery and then took an intramural course in the LSV with normal distal branching. Inside the aorta a "dimple" was observed at the usual site of the LCA origin. A button was transferred to the aorta. Transesophageal echocardiographic analysis demonstrated antegrade LCA flow on cardiopulmonary bypass that was not demonstrable after weaning. The transferred coronary artery was revised by opening the ostium into the distal part of the intramural segment. The opened proximal LCA, . . . [Full Text of this Article]




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T. K. S. Kumar, P. Sinha, M. T. Donofrio, and R. A. Jonas
Anomalous left coronary artery from the right pulmonary artery with aortic fusion
J. Thorac. Cardiovasc. Surg., February 1, 2012; 143(2): 505 - 507.
[Full Text] [PDF]


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