ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2024
vol. 89
 
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Cardiovascular radiology
abstract:
Original paper

Anomalous left coronary artery from the pulmonary artery (ALCAPA) in adult patients – a multimodality imaging approach

Alexander Suchodolski
1, 2
,
Jan Głowacki
3, 4
,
Jarosław Wasilewski
5
,
Mariola Szulik
2, 6

1.
Doctoral school, Department of Cardiology and Electrotherapy, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
2.
Department of Cardiology and Electrotherapy, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
3.
Department of Radiology and Radiodiagnostics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
4.
Computed Tomography Laboratory, Silesian Centre for Heart Diseases, Zabrze, Poland
5.
Third Department of Cardiology, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
6.
Department of Medical and Health Sciences, WSB University Faculty of Applied Sciences, Dąbrowa Górnicza, Poland
© Pol J Radiol 2024; 89: e115-e121
Online publish date: 2024/02/27
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Purpose:
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital ano­maly of the origin of the coronary arteries. The prevalence of this anomaly in the adult patient population is low, and therefore there is virtually no original research on this topic. Reports are limited to case reports.

Material and methods:
We evaluated 16,264 computed tomography (CT) exams (cardiac and chest) performed in our heart imaging department between 2015 and 2022 on a dual source 128-slice CT scanner (SOMATOM Definition Flash, Siemens Healthineers, Forchheim, Germany) and established a retrospective registry of adult patients (> 18 years old) with ALCAPA. The study included 7 cases. Next, we collected clinical and echocardiographic data, which could be assessed retrospectively.

Results:
We found 7 cases of ALCAPA in adult patients (0.043%). Three of them were female, and 4 were male. The age varied between 20 and 60 years. Echocardiographic findings, as well as the clinical course, varied widely.

Conclusions:
ALCAPA is an extremely rare anomaly, which nonetheless must be taken into clinical consideration. This lesion may be fatal during infancy. Data regarding adult patients is scarce. Multicentre registries are needed to establish a more detailed clinical profile of adults with this anomaly.

keywords:

coronary anomaly, computed tomography, congenital heart disease




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