Bhende Vishal V, Sharma Tanishq S, Majmudar Hardil P, Pathan Sohilkhan R, Mehta Deepak V
Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Karamsad, IND.
Medicine, Shree Krishna Hospital, Karamsad, IND.
Cureus. 2021 Aug 27;13(8):e17493. doi: 10.7759/cureus.17493. eCollection 2021 Aug.
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease that may present isolated or may be associated with other cardiac malformations. Most of the patients develop symptoms during infancy but some may remain asymptomatic up to adulthood. Symptoms range from mild distress to severe irritability and feed intolerance. We report a case of a five-month-old male child who presented with congestive heart failure and was diagnosed as a case of ALCAPA with left atrial and left ventricular dilation based on two-dimensional echocardiography and computed tomography (CT) coronary angiogram. Left main coronary artery was shown to be arising from the posteroinferior wall of main pulmonary artery. Various surgical approaches have been suggested in the repair but the Takeuchi technique was preferred owing to its origin from the non-facing sinus of the pulmonary artery and co-existing dilatation of left atria and ventricle. The surgery was uneventful and there were no postoperative complications. A cardiac CT dynamic study was also done on the follow-up visit five months later and no signs of abnormality or complications were reported. Early intervention is necessary to prevent irreversible cardiac complications and early mortality.
起源于肺动脉的异常左冠状动脉（ALCAPA）是一种罕见的先天性心脏病，可单独出现，也可能与其他心脏畸形相关。大多数患者在婴儿期出现症状，但有些患者可能直到成年都无症状。症状从轻度不适到严重烦躁和喂养不耐受不等。我们报告一例五个月大男童，表现为充血性心力衰竭，基于二维超声心动图和计算机断层扫描（CT）冠状动脉造影，被诊断为伴有左心房和左心室扩张的ALCAPA病例。左冠状动脉主干显示起源于主肺动脉的后下壁。修复手术已提出多种手术方法，但由于其起源于肺动脉的非面对窦以及左心房和心室同时存在扩张，故首选竹内技术。手术过程顺利，术后无并发症。五个月后的随访中还进行了心脏CT动态研究，未报告异常或并发症迹象。早期干预对于预防不可逆的心脏并发症和早期死亡是必要的。
