Anomalous left coronary artery from pulmonary artery (ALCAPA) in infants: a 5-year review in a defined birth cohort

Zeitschrift für Kinderheilkunde - Tập 167 - Trang 43-46 - 2007
Helen Brotherton1, Roy K. Philip1
1Mid-Western Regional and Maternity Hospitals, Limerick, Ireland

Tóm tắt

Anomalous left coronary artery from pulmonary artery (ALCAPA) is a rare congenital cardiac malformation. It presents predominantly in infancy with features of myocardial ischaemia or cardiac failure and may be mistaken for common paediatric conditions such as colic, reflux or bronchiolitis. With early surgical correction the prognosis is good, but awareness of this condition is essential for prompt diagnosis and referral to a tertiary cardiac centre. In this report we review the five cases that presented during our 5-year study period and discuss the incidence and clinical presentation of ALCAPA among infants. Our observed incidence of 1 in 4243 live births – 0.023 % – is higher than previously reported. ALCAPA may be more common than previously recognised, and there should be a high index of awareness among paediatricians, paediatric trainees and general practitioners to enable early surgical intervention and improved prognosis for these children.

Tài liệu tham khảo

Alexi-Meskishvili V, Berger F, Weng Y, Lange PE, Hetzer R (1995) Anomalous origin of the left coronary artery from the pulmonary artery in adults. J Card Surg 10(4):309–315 Amaral F, Carvalho JS, Granzotti JA, Shinebourne EA (1999) Anomalous origin of the left coronary artery from the pulmonary trunk. Clinical features and midterm results after surgical treatment. Arq Bras Cardiol 72(3):307–320 Artman M, Mahony C, Teitel DF (2002) Neonatal cardiology. McGraw-Hill, New York Behrman RE, Kliegman RM, Jenson HB (2004) Nelson textbook of pediatrics, 17th edn. W.B. Saunders, Philadelphia Dancea A, Cote A, Rohlicek C, Bernard C, Oligny LL (2002) Cardiac pathology in sudden unexpected infant death. J Pediatr 141(3):336–342 Davis JA, Cecchin F, Jones TK, Portman MA (2001) Major coronary artery anomalies in a pediatric population: Incidence and clinical importance. Pediatr Cardiol 37(2):593–597 Heifetz SA, Robinowitz M, Mueller KH, Virmani R (1986) Total anomalous origin of the coronary arteries from the pulmonary artery. Pediatr Cardiol 7(1):11–18 Julian DG, Camm AJ, Fox KM, Hall RJC, Poole-Wilson PA (eds) (1996) Diseases of the heart, 2nd edn. W.B. Saunders, London Kandzari DE, Harrison JK, Behar VS (2002) An anomalous left coronary artery originating from the pulmonary artery in a 72 year old woman: diagnosis by color flow myocardial blush and coronary arteriography. J Invasive Cardiol 14(2):96–99 Kardos A, Babai L, Rudas L, Gaal T, Horvath T, Talosi L (1997) Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. Cathet Cardiovasc Diagn 42(3):276–277 Lipsett J, Cohle SD, Berry PJ, Russel G, Byard RW (1994) Anomalous coronary arteries: a multicenter pediatric autopsy study. Pediatr Pathol 14(2):287–300 Mahle WT (1998) A dangerous case of colic: anomalous left coronary artery presenting with paroxysms of irritability. Pediatr Emerg Care 14(1):24–27 Park MK, Troxler RG (2002) Pediatric cardiology for paediatricians, 4th edn. Mosby, Philadelphia Pillai SB, Khan MM, Diamond A, McKeown PP (2000) The Prevalence and types of coronary artery anomalies in Northern Ireland. Ulster Med J 69(1):19–22 Rasten-Almqvist P, Rajs J (2004) Cardiovascular malformations and sudden death in infancy. Am J Foren Med Pathol 25(2):134–140 Valdes-Dapena M, Gilbert-Barness E (2002) Cardiovascular causes for sudden infant death. Pediatr Pathol Mol Med 21(2):195–211 Werner B, Wroblewska-Kaluzewska M, Pleskot M, Tarnowska A, Potocka K (2001) Anomalies of the coronary arteries in children. Med Sci Monit 7(6):1285–1291 Wilson CL, Dlabal PW, Holeyfield RW, Akins CW, Knauf DG (1977) Anomalous origin of left coronary artery from pulmonary artery. Case report and review of literature concerning teenagers and adults. J Thorac Cardiovasc Surg 73(6):887–893