Kong Ling-Qiu, Zhang Li, Feng Yuan, Kang Yu, Wang Fang, Tang Hong
Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Apr;41(4):297-300.
To summarize the echocardiographic features of anomalous left coronary artery from the pulmonary artery (ALCAPA).
A study was performed on 10 patients with ALCAPA retrospectively and the result was compared with coronary angiography to summarize its echocardiographic features.
Of the 10 patients with ALCAPA, there were 3 cases of infantile type and 7 cases of adult type. Left ventricular cavity was enlarged and the anterior and lateral wall motion was reduced in all patients with the infantile type ALCAPA. The trunk and branch of the right coronary artery was enlarged in patients with the adult type, meanwhile the diastolic blood flow signal could be detected in inter-ventricular septum and in the area supplied by the left anterior descending coronary artery. The trunk of the left coronary artery originated from the pulmonary artery in 7 patients, the left circumflex artery originated from the pulmonary artery in another 3 patients. Diastolic blood flow signal could be detected by the Doppler echocardiogram in the pulmonary artery in all patients. One patient was misdiagnosed as coronary artery fistula, and correct diagnosis was made by the coronary angiography. In 1 patient, echocardiography examination suggested that the left coronary artery was originated from left coronary aortic sinus and angiography results showed that the left coronary artery was originated from the right posterior sinus of the pulmonary artery. Eight ALCAPA patients suffered from other cardiovascular abnormalities, including atrial septum defect, ventricular septal defect and non-compaction of ventricular myocardium.
Abnormal connection of the left coronary artery with pulmonary artery and diastolic blood flow are typical echocardiographic findings in patients with ALCAPA. Coronary angiography serves as an important tool for the correct diagnosis of ALCAPA.
总结肺动脉起源的异常左冠状动脉（ALCAPA）的超声心动图特征。
对10例ALCAPA患者进行回顾性研究，并将结果与冠状动脉造影进行比较，以总结其超声心动图特征。
10例ALCAPA患者中，婴儿型3例，成人型7例。婴儿型ALCAPA患者均有左心室腔扩大，前壁和侧壁运动减弱。成人型患者右冠状动脉主干及分支增粗，同时在室间隔及左前降支供血区域可检测到舒张期血流信号。7例患者左冠状动脉主干起源于肺动脉，另外3例患者左旋支起源于肺动脉。所有患者经多普勒超声心动图均可在肺动脉内检测到舒张期血流信号。1例患者误诊为冠状动脉瘘，经冠状动脉造影明确诊断。1例患者超声心动图检查提示左冠状动脉起源于左冠状动脉主动脉窦，造影结果显示左冠状动脉起源于肺动脉右后窦。8例ALCAPA患者合并其他心血管异常，包括房间隔缺损、室间隔缺损及心室心肌致密化不全。
左冠状动脉与肺动脉的异常连接及舒张期血流是ALCAPA患者典型的超声心动图表现。冠状动脉造影是正确诊断ALCAPA的重要手段。
