Pediatric Cardiology and Cardiac Surgery
Online ISSN : 2187-2988
Print ISSN : 0911-1794
ISSN-L : 0911-1794
Case Report
A Case of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Developed Acute Heart Failure by Transcatheter Ductus Arteriosus Closure
Hidenori Yamamoto , Naoki Ohashi, Hiroshi Nishikawa, Sho Takeda, Shuichiro Yoshida, Kazutaka Suzuki, Daisuke Omori, Jun Sato, Hajime Sakurai, Toshimichi Nonaka, Takahisa Sakurai, Motoshi Kosakai, Mika Noda, Takuya Osawa
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Keywords: anomalous origin of the left coronary artery from the pulmonary artery, patent ductus arteriosus, acute myocardial infarction, catheter intervention, preoperative diagnosis
JOURNAL OPEN ACCESS

2016 Volume 32 Issue 6 Pages 518-523

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Abstract

A 12-month-old boy who was diagnosed with a large patent ductus arteriosus (PDA) and pulmonary hypertension (PH) in another hospital was admitted to Chukyo Children Heart Center for catheter intervention. After transcatheter PDA closure, he developed myocardial dysfunction accompanied by elevated cardiac enzyme levels and an abnormal Q-wave on electrocardiography. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was detected on follow-up transthoracic echocardiography, and open chest surgery was performed. ALCAPA typically manifests in infancy with signs and symptoms of heart failure that are secondary to ischemic cardiomyopathy. However, it is very difficult to diagnose when additional congenital heart disease, for example, PDA, is present, because left coronary perfusion is maintained by PH. If PDA is treated without the diagnosis of ALCAPA, sudden deterioration may occur. We concluded that we should confirm the origin of the coronary artery using left ventriculography or aortography before transcatheter PDA closure if we cannot rule out the possibility of coronary artery anomalies by careful transthoracic echocardiography.

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© 2016 Japanese Society of Pediatric Cardiology and Cardiac Surgery
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