Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-30T22:53:28.161Z Has data issue: false hasContentIssue false

Resection of a cardiac aneurysm in an infant with anomalous origin of the left coronary artery from the pulmonary trunk

Published online by Cambridge University Press:  20 January 2005

Heynric B. Grotenhuis
Affiliation:
Department of Pediatric Intensive Care, University Hospital Nijmegen, Nijmegen, The Netherlands
Ad Backx
Affiliation:
Department of Pediatric Intensive Care, University Hospital Nijmegen, Nijmegen, The Netherlands
Aagje Nijveld
Affiliation:
Department of Pediatric Intensive Care, University Hospital Nijmegen, Nijmegen, The Netherlands

Abstract

We describe an infant with an anomalous left coronary artery arising from the pulmonary trunk leading to myocardial ischaemia and development of an apical aneurysm of the left ventricle.

Clinical presentation in general is based on myocardial hypoperfusion resulting in ischaemia and infarction. When presenting in infancy, however, then the features, as in our patient, may be tachypnea, dyspnea, failure to thrive and irritability, especially during feeding. Then, again as in our patient, it is possible to miss the definitive diagnosis, which is made by echocardiography and cardiac catheterization. Reimplantation of the anomalous left coronary artery into the aorta usually results in improvement of left ventricular function over time. In our patient, the myocardial infarction was complicated by formation of an aneurysm, and reimplantation alone was not sufficient to restore cardiac function. Resection of the aneurysm greatly improved the hemodynamics.

Type
Brief Report
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agustsson M, Gasul B, Fell E, Graettinger J, Bicoof J, Waterman D. Anomalous origin of the left coronary artery from the pulmonary artery: diagnosis and treatment of infantile and adult types. JAMA 1962; 180: 1521.Google Scholar
Chu E, Cheitlin MD. Diagnostic considerations in patients with suspected coronary artery anomalies. Am Heart J 1993; 126: 14271438.Google Scholar
Keith JD. The anomalous origin of the left coronary artery from the pulmonary artery. Br Heart J 1959; 21: 149161.Google Scholar
Jin Z, Berger F, Uhlemann F, et al. Improvement in left ventricular dysfunction after aortic reimplantation in 11 consecutive pediatric patients with anomalous origin of the left coronary artery from the pulmonary artery. Eur Heart J 1994; 15: 10441049.Google Scholar
Grossi E, Colvin S, Galloway A, et al. Repair of posterior left ventricular aneurysm in a six-year-old boy. Ann Thorac Surg 1991; 51: 484487.Google Scholar
Yam M, Menahem S. Mitral valve replacement for severe mitral regurgitation in infants with anomalous left coronary artery from the pulmonary artery. Pediatr Cardiol 1996; 17: 271274.Google Scholar
Shivalkar B, Borgers M, Daenen W, Gewillig M, Flameng W. ALCAPA syndrome: an example of chronic myocardial hypoperfusion? JACC 1994; 23: 772778.Google Scholar