1/1402. Anomalous left coronary artery arising from right sinus of valsalva could be a minor congenital anomaly--a case report and review of the literature. Left coronary artery arising from the right sinus of valsalva is a rare congenital coronary anomaly. This anomaly is either benign or serious, depending on the relation of the anomalous left coronary artery to the aorta and pulmonary artery. Potentially serious anomaly is associated with sudden cardiac death and warrants prophylactic coronary bypass surgery. A rare case of anomalous left coronary artery arising from the right sinus of valsalva is reported, documented by coronary angiography; however, it took a safer course between the aorta and pulmonary artery. Prophylactic surgery was not performed, for this benign anomaly may not carry the same risk of sudden cardiac death. ( info) |
2/1402. Anomalous origin of the left coronary artery from the pulmonary artery: natural history and normal pregnancies. Two female patients are described with anomalous origin of the left coronary artery arising from the pulmonary artery who sustained an anterolateral myocardial infarction in infancy. Neither patient received surgical treatment although both have lived to middle age with minimal cardiovascular problems and have had uncomplicated pregnancies. Good exercise tolerance and long term survival may be possible even without surgery for patients with this anomaly. ( info) |
3/1402. Anomalous origin of the right coronary artery from the left sinus of valsalva: transthoracic echocardiographic diagnosis. Anomalous origin of the right coronary artery from the left sinus of valsalva is a rare congenital defect that can be difficult to diagnose by echocardiography. We describe an infant with a ventricular septal defect that was diagnosed prospectively by transthoracic echocardiography as an anomalous origin of the right coronary artery from the left sinus of valsalva. Subcostal imaging and Doppler color flow mapping were instrumental in the echocardiographic diagnosis of this unusual coronary abnormality. ( info) |
4/1402. Successful total correction of complete atrioventricular canal, total anomalous pulmonary venous drainage and unroofed coronary sinus in an infant. An infant with complete atrioventricular canal, total anomalous pulmonary venous drainage into the left superior vena cava and an unroofed coronary sinus successfully underwent total correction. A homograft vein was used to connect the proximal left superior vena cava to the right atrium and can be recommended when other methods of correction of unroofed coronary sinus cannot be used. ( info) |
5/1402. Aortopulmonary window with anomalous origin of the right coronary artery. We report a case of an aortopulmonary window with a right coronary artery arising from the pulmonary trunk. This exceedingly rare anomaly with anomalous coronary artery presented without myocardial ischemia owing to the aortopulmonary window. The correct diagnosis was made by angiography and a successful surgical correction was performed. ( info) |
6/1402. Incipient left ventricular rupture complicating anomalous left coronary artery. A 4-month-old girl presented with 2 weeks of symptoms and physical signs of heart failure. echocardiography demonstrated marked left ventricular dilation, thinning of the myocardium with anterolateral akinesis, mitral regurgitation, a moderate pericardial collection, and an anomalous left coronary artery from the pulmonary artery. At operation there was a tense hemopericardium and a site of imminent rupture through a transmural anterior infarction. The anomalous artery was reimplanted in the ascending aorta, and an extensive infarct resection and ventricular repair performed. Support with a left ventricular assist device was required for 3 days, but the infant subsequently made a satisfactory recovery. Left ventricular rupture is a very rare complication of this lesion, but should be considered if there is evidence of a pericardial collection. ( info) |
7/1402. Single coronary artery with "high take-off" origin in a patient with rheumatic mitral stenosis--a case report. In this case report, a patient with rheumatic mitral stenosis and R-1 subtype single coronary artery arising from the ascending aorta ("high take-off" origin) and coursing between the aorta and pulmonary artery is presented. The clinical significance and differential diagnosis are discussed. To the authors' knowledge, this is the first case reported in the literature with a single R-1 subtype coronary artery that shows "high take-off" origin. ( info) |
8/1402. Treatment of a large congenital coronary fistula with coil embolization. A 77-year-old woman suffering from progressive dyspnea and chest pain for 2 1/2 years was admitted to hospital. There were no ECG changes at exercise test and a dobutamine stress echocardiography was normal. At catheterization, right-sided pressures were within normal limits. coronary angiography revealed a congenital coronary fistula, 3-4 mm in diameter, from the left anterior descending artery to the proximal pulmonary artery. There was no significant rise in blood oxygen saturation in the pulmonary artery. Transcatheter coil embolization was performed in the distal part of the tortuous fistula. Flow ceased within minutes, demonstrating the feasibility and efficacy of this technique for treating large fistulas. ( info) |
9/1402. The physiology of congenital heart disease: assessment by Doppler color flow mapping. The use of Doppler echocardiography is a routine part of the noninvasive assessment of the patient with heart disease. In children with congenital heart disease, pulsed- and continuous-wave Doppler echocardiographic techniques provide accurate, reproducible hemodynamic data relative to structural defects. Doppler color flow imaging, however, allows for qualitative assessment of blood flow patterns, which may give important insights into the changing physiology of the newborn infant or that of a patient in the medical or surgical intensive care settings. Ten cases are presented in which this flow information is instructive in understanding the physiological sequelae of congenital heart disease. ( info) |
10/1402. Multivessel coronary angioplasty with anomalous origin of the left main coronary artery. We report a case of coronary angioplasty to the right coronary artery, the circumflex, and the left anterior descending artery in a patient with anomalous left main coronary artery arising from the right aortic sinus of valsalva. At angiographically documented follow-up of more than 2 years, the patient remains well without restenosis. This case represents the only such report in the literature. angioplasty hardware was an important factor in successful crossing and dilatation of multiple severe and distal stenoses in the anomalous left system; appropriate technical details are discussed. ( info) |