Kristensen Thomas, Kofoed Klaus Fuglsang, Helqvist Steffen, Helvind Morten, Søndergaard Lars
Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Denmark.
J Cardiothorac Surg. 2008 May 26;3:33. doi: 10.1186/1749-8090-3-33.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. The usual clinical course is severe left sided heart failure and mitral valve insufficiency presenting during the first months of life. However, in some cases collateral blood supply from the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion. Coronary angiography and CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images before and after surgery.
左冠状动脉起源于肺动脉（ALCAPA）是一种罕见的先天性异常。通常的临床病程是在生命的最初几个月出现严重的左侧心力衰竭和二尖瓣关闭不全。然而，在某些情况下，右冠状动脉的侧支血供充足，症状可能不明显甚至没有症状。成年期的心律失常或心源性猝死可能是ALCAPA患者的首发临床表现。我们报告一例病例，一名39岁女性在体力活动时出现心室颤动。冠状动脉造影和CT血管造影显示左冠状动脉起源异常，随后进行了左冠状动脉主动脉再植术并植入了植入式心律转复除颤器（ICD）。本文结合手术前后的CT图像对ALCAPA的文献进行了综述。
