Anomalous Origin of the Left Coronary Artery from the Pulmonary Trunk
Open Access
- 1 August 1968
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 38 (2), 403-425
- https://doi.org/10.1161/01.cir.38.2.403
Abstract
The congenital anomaly in which the left coronary artery arises from the main pulmonary artery is infrequent, but lethal, and since it can be alleviated surgically, its recognition and hemodynamic consequences are important. On the basis of 140 reported cases and our seven cases, it seems to present in one of four ways: (1) in infancy with angina-like symptoms or as cardiomyopathy, and later (2) as mitral insufficiency, (3) continuous murmur, or in adults (4) by sudden death. Visualization of the coronary arteries provides the definitive diagnosis, and the problem is the selection for this procedure. The electrocardiogram, the most helpful laboratory aid, is diagnostic of infarction in 80% of the infant group; in the remainder other forms of cardiomyopathy may be confused. Although blood flows directly into the pulmonary artery in the majority of cases, it flows in the reverse direction in a few and this must be determined preoperatively. Some unanswered questions are the subject of discussion: Why the majority of infants have onset of symptoms at about 8 weeks of age, and why some survive to childhood and adult life. The pathological findings are reviewed. Although the greatest surgical therapy experience has been with obliteration of the anomalous left coronary artery (ALCA) at its connection with the pulmonary artery, anastomosis between aorta and ALCA provides an additive supply for both the present and the future.This publication has 39 references indexed in Scilit:
- The anatomy and blood supply of the papillary muscles of the left ventricleAmerican Heart Journal, 1966
- The vascular supply of the left ventricular wall: Anatomic observations, plus a hypothesis regarding acute events in coronary artery diseaseAmerican Heart Journal, 1966
- Anomalous left coronary artery arising from the pulmonary artery with large left-to-right shunt in infancyThe Journal of Pediatrics, 1963
- The Direction of Blood Flow in Anomalous Left Coronary Artery Arising from the Pulmonary ArteryCirculation, 1960
- Anomalous left coronary artery. Adult typeAmerican Heart Journal, 1960
- Anomalous left coronary artery: Adult typeAmerican Heart Journal, 1957
- Anomalous left coronary artery arising from the pulmonary artery: Report of a case and surgical considerationThe Journal of Pediatrics, 1955
- Anomalous left coronary artery arising from the pulmonary artery (adult type)American Heart Journal, 1950
- Origin of left coronary artery from pulmonary artery: Review of the literature and report of two casesAmerican Heart Journal, 1947
- The relation of the weight of the heart to the weight of the body and of the weight of the heart to ageAmerican Heart Journal, 1928