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Case Series
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| Anomalous origins of a coronary artery from the pulmonary artery: A series of three case reports undetected into adulthood | ||||||
| Katie L. Mastoris1, Ataul Qureshi2, Navin K. Subrayappa2, Matthew W. Martinez2, James Wu3 | ||||||
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1D. O, Department of Medicine, Lehigh Valley Health Network, Allentown PA.
2MD, Division of Cardiology, Department of Medicine, Lehigh Valley Health Network, Allentown PA. 3MD, Division of Cardiothoracic Surgery, Department of Surgery, Lehigh Valley Health Network, Allentown PA. | ||||||
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| How to cite this article |
| Mastoris KL, Qureshi A, Subrayappa NK, Martinez MW, Wu J. Anomalous origins of a coronary artery from the pulmonary artery: A series of three case reports undetected into adulthood. Int J Case Rep Images 2015;6(7):391–395. |
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Abstract
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Introduction:
An anomalous origin of the coronary artery from the pulmonary artery (ACAPA) is a rare congenital anomaly resulting in sudden death in 90% of infants during their first year of life. Diagnosis in living adults is particularly unusual, especially for left coronary artery arising from the pulmonary artery (ALCAPA) given the large perfusion distribution that the left system provides to the myocardium. Surgery to correct and restore a bi-coronary arterial circulatory system has historically been the standard of treatment given the lethality of the diagnosis. However, advances in coronary imaging have led to an increased incidence of diagnosis in adulthood and challenges the true association between sudden death and ACAPA. This makes the decision for surgical correction more complex.
Case Series: Herein, we presented three cases of coronary anomalies arising from the pulmonary artery that remained undetected until adulthood, only one of which was managed surgically. Conclusion: Currently, the prevalence of ACAPA in adults is low. Hence, there is no strong evidence based recommendations for management of adult patients. With advances in diagnostic modalities and potentially an increase in reported ACAPA cases, more data will become available to helpguide the decision of surgical verses medical management. | |
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Keywords:
Anomalies, Cardiac surgery, Chest pain, Coronary vessel, Pulmonary artery
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Author Contributions:
Katie L. Mastoris – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Ataul Qureshi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Navin K. Subrayappa – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Matthew W. Martinez – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published James Wu – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Katie L. Mastoris et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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