Kale Suresh Babu, Raghavan Jagannathan
Institute for Cardiac Treatment and Research, Southern Railway Headquarter Hospital, Perambur, Chennai, India.
J Card Surg. 2012 May;27(3):325-7. doi: 10.1111/j.1540-8191.2011.01403.x. Epub 2012 Jan 26.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) syndrome is a rare congenital coronary artery anomaly especially when diagnosed in an adult patient and remains an important cause of sudden cardiac death. We report a 46-year-old patient with ALCAPA syndrome managed with left main coronary artery (LMCA) interruption and grafting of the LMCA with left internal mammary artery so as to restore antegrade coronary flow. This approach of restoring dual-coronary-artery system by grafting the LMCA allows antegrade blood flow as in a normal coronary artery to a large area of viable myocardium, is more physiological, and is practical and easy to accomplish in an anteriorly placed and dilated LMCA as seen in our case.
左冠状动脉起源于肺动脉（ALCAPA）综合征是一种罕见的先天性冠状动脉异常，尤其是在成年患者中被诊断出来时，它仍然是心源性猝死的一个重要原因。我们报告了一名46岁患有ALCAPA综合征的患者，通过中断左冠状动脉主干（LMCA）并将LMCA与左乳内动脉进行移植来恢复冠状动脉顺行血流。通过移植LMCA来恢复双冠状动脉系统的这种方法，能使大面积存活心肌如同在正常冠状动脉中一样实现顺行血流，更符合生理，并且在我们病例中所见到的位于前方且扩张的LMCA情况下切实可行且易于完成。
