Case report
A rare case of anomalous origin of the left main coronary artery in an adult patient
1 Division of cardiac surgery, Centre Hospitalier de l’Université de Montréal (CHUM), St Urbain Street, Montréal, H2W 1T8, Canada
2 Division of cardiac surgery, Centre Hospitalier Universitaire Mère-Enfant (CHU-ME), Chemin de la Côte-Sainte-Catherine, Montréal, H3T 1C5, Canada
3 Division of cardiac surgery, Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de recherche du CHUM (CRCHUM), St Urbain Street, Montréal, H2W 1T8, Canada
4 Department of radiology, Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de recherche du CHUM (CRCHUM), St Urbain Street, Montréal, H2W 1T8, Canada
5 Division of cardiology, Centre Hospitalier de l'Université de Montréal (CHUM) et Centre de recherche du CHUM (CRCHUM), St Urbain Street, Montréal, H2W 1T8, Canada
Journal of Cardiothoracic Surgery 2013, 8:15 doi:10.1186/1749-8090-8-15
Published: 22 January 2013Abstract
Anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that causes a left-to-right shunt via the coronary system, resulting in coronary steal. We report an unusual case of a healthy 48 years-old patient presenting with dyspnea on exertion and mild chest pain who underwent surgical correction of this rare anomaly. Multiple procedures have been proposed in adults with ALCAPA. Although re-implantation of the left main coronary artery (LMCA) to the aorta remains the most physiological correction for this anomaly, the combination of LMCA ligation and coronary artery bypass grafting provides a dual coronary flow system and is preferable when re-implantation is impossible.
