Lam John C, Giuffre Michael, Myers Kimberley A
John C Lam, Michael Giuffre, Kimberley A Myers, Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta T3B 6A8, Canada.
World J Cardiol. 2014 Aug 26;6(8):874-7. doi: 10.4330/wjc.v6.i8.874.
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is most commonly diagnosed within the first year of life with congestive heart failure symptomatology reflecting left ventricle (LV) dysfunction. The late diagnosis of ALCAPA is presented in a 5-year-old without significant LV dysfunction, mild LV dilatation and only mild mitral regurgitation that did not change significantly after surgery. The timing of surgical intervention in the late diagnosis of ALCAPA remains unclear despite risks of significant ongoing myocardial injury secondary to coronary artery hypoperfusion and progressive mitral valve dysfunction. Intervention in this case allows for revascularization which may reverse ventricular and valvular dysfunction.
起源于肺动脉的异常左冠状动脉（ALCAPA）最常在出生后第一年内被诊断出来，伴有反映左心室（LV）功能障碍的充血性心力衰竭症状。本文报告了一名5岁的ALCAPA患者，其诊断较晚，左心室功能无明显异常，仅有轻度左心室扩张和轻度二尖瓣反流，术后无明显变化。尽管存在因冠状动脉灌注不足和二尖瓣功能进行性障碍导致严重持续性心肌损伤的风险，但ALCAPA晚期诊断的手术干预时机仍不明确。该病例的干预实现了血运重建，可能逆转心室和瓣膜功能障碍。
