Hagău Asmaa Carla, Suciu Horațiu, Popoiu Anca Voichița, Muntean Iolanda
Doctoral School of Medicine and Pharmacy, I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania.
Clinic of Paediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, 540139 Târgu Mureș, Romania.
J Cardiovasc Dev Dis. 2024 Jul 11;11(7):219. doi: 10.3390/jcdd11070219.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare and potentially life-threatening condition affecting infants that requires immediate corrective surgery to restore blood flow to the myocardium. We present a case of an infant with ALCAPA and severe heart failure. What sets this case apart is the utilization of speckle-tracking echocardiography as a non-invasive method for assessing global and regional myocardial function before and after surgical intervention. Our preoperative analysis revealed compromised contraction in specific areas of the left ventricle (LV), in the regions that were supplied by both the left coronary artery (LCA) and the right coronary artery (RCA). Interestingly, despite an increase in ejection fraction (EF) measured by conventional echocardiography, the postoperative speckle-tracking analysis revealed persistent impairment in the anterior territories supplied by LCA, highlighting the potential of this technique in identifying myocardial abnormalities during postoperative follow-up. In conclusion, speckle-tracking echocardiography may be a valuable tool for identifying subtle myocardial changes in ALCAPA patients with a higher sensitivity in detecting regional left ventricular (LV) dysfunction compared to conventional echocardiography.
左冠状动脉起源于肺动脉（ALCAPA）是一种罕见且可能危及生命的疾病，影响婴儿，需要立即进行矫正手术以恢复心肌的血流。我们报告一例患有ALCAPA和严重心力衰竭的婴儿病例。该病例的独特之处在于，在手术干预前后，利用斑点追踪超声心动图作为一种非侵入性方法来评估整体和局部心肌功能。我们的术前分析显示，在左冠状动脉（LCA）和右冠状动脉（RCA）共同供血的左心室（LV）特定区域，收缩功能受损。有趣的是，尽管传统超声心动图测量的射血分数（EF）有所增加，但术后斑点追踪分析显示，LCA供血的前壁区域仍存在持续损伤，突出了该技术在术后随访中识别心肌异常的潜力。总之，斑点追踪超声心动图可能是一种有价值的工具，用于识别ALCAPA患者细微的心肌变化，与传统超声心动图相比，其在检测局部左心室（LV）功能障碍方面具有更高的敏感性。
