Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adult Patients

pp 617-620

Abstract

Anomalous origin of the left coronary artery from the pulmonary artery is a rare entity, with an ominous prognosis. This anomaly presents a high mortality rate in the first years of life, and the few of those who survive until adulthood have a high risk of myocardial infarction, heart failure and suden death. We report a case of a 18 year-old female who complained of effort-induced angina and dyspnea. Both exercise testing and Thallium 201-stress perfusion imaging showed evidence of myocardial ischemia. Diagnosis of anomalous origin of the left coronary artery from the pulmonary artery was established by coronariography and aortography. The patient underwent surgical reimplantation of the left coronary ostium, from the pulmonary artery to the aortic root, without complications.The favourable outcome should be remarked, since neither development of myocardial infarction nor ventricular disfunction were present, probably related to the significant development of the right coronary artery and the collateral circulation to the left coronary artery.