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Open Access Case report

A rare case of anomalous origin of the left main coronary artery in an adult patient

Pierre O Dionne1, Nancy Poirier2, Jessica Forcillo1, Louis M Stevens3, Carl Chartrand-Lefebvre4, Samer Mansour5 and Nicolas Noiseux3*

Author Affiliations

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

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Journal of Cardiothoracic Surgery 2013, 8:15  doi:10.1186/1749-8090-8-15

Published: 22 January 2013

Abstract

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.

Keywords:
Congenital heart defect; Cardiac surgery; Coronary artery bypass graft