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Left Coronary Artery Anomalous Origin
Ryan A. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) = Bland-White-Garland (BWG) syndrome
        • Definitions

          • ALCAPA: Most common congenital coronary artery anomaly presenting in children
            • Causes cardiac ischemia & infarction, depressed left ventricular (LV) systolic function, & significant mitral valve regurgitation

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • MR Findings

                • Echocardiographic Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Li RJ et al: Diagnostic value of transthoracic echocardiography in patients with anomalous origin of the left coronary artery from the pulmonary artery. Medicine (Baltimore). 95(15):e3401, 2016
                                      2. Naimo PS et al: Surgical intervention for anomalous origin of left coronary artery from the pulmonary artery in children: a long-term follow-up. Ann Thorac Surg. 101(5):1842-8, 2016
                                      3. Baraona F et al: Coronary arteries in childhood heart disease: implications for management of young adults. J Clin Exp Cardiolog. 2012
                                      4. Shriki JE et al: Identifying, characterizing, and classifying congenital anomalies of the coronary arteries. Radiographics. 32(2):453-68, 2012
                                      5. Fehrenbacher TA et al: Surgery and critical care for anomalous coronary artery from the pulmonary artery. Cardiol Young. 20 Suppl 3:35-43, 2010
                                      6. Peña E et al: ALCAPA syndrome: not just a pediatric disease. Radiographics. 29(2):553-65, 2009
                                      7. Friedman AH et al: Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children. Cardiol Young. 17 Suppl 2:56-67, 2007
                                      8. Deibler AR et al: Imaging of congenital coronary anomalies with multislice computed tomography. Mayo Clin Proc. 79(8):1017-23, 2004
                                      9. Frommelt PC et al: Congenital coronary artery anomalies. Pediatr Clin North Am. 51(5):1273-88, 2004
                                      10. Schoenhagen P et al: Noninvasive imaging of coronary arteries: current and future role of multi-detector row CT. Radiology. 232(1):7-17, 2004
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Synonyms

                                              • Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) = Bland-White-Garland (BWG) syndrome
                                            • Definitions

                                              • ALCAPA: Most common congenital coronary artery anomaly presenting in children
                                                • Causes cardiac ischemia & infarction, depressed left ventricular (LV) systolic function, & significant mitral valve regurgitation

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Echocardiographic Findings

                                                      • Angiographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Li RJ et al: Diagnostic value of transthoracic echocardiography in patients with anomalous origin of the left coronary artery from the pulmonary artery. Medicine (Baltimore). 95(15):e3401, 2016
                                                                          2. Naimo PS et al: Surgical intervention for anomalous origin of left coronary artery from the pulmonary artery in children: a long-term follow-up. Ann Thorac Surg. 101(5):1842-8, 2016
                                                                          3. Baraona F et al: Coronary arteries in childhood heart disease: implications for management of young adults. J Clin Exp Cardiolog. 2012
                                                                          4. Shriki JE et al: Identifying, characterizing, and classifying congenital anomalies of the coronary arteries. Radiographics. 32(2):453-68, 2012
                                                                          5. Fehrenbacher TA et al: Surgery and critical care for anomalous coronary artery from the pulmonary artery. Cardiol Young. 20 Suppl 3:35-43, 2010
                                                                          6. Peña E et al: ALCAPA syndrome: not just a pediatric disease. Radiographics. 29(2):553-65, 2009
                                                                          7. Friedman AH et al: Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children. Cardiol Young. 17 Suppl 2:56-67, 2007
                                                                          8. Deibler AR et al: Imaging of congenital coronary anomalies with multislice computed tomography. Mayo Clin Proc. 79(8):1017-23, 2004
                                                                          9. Frommelt PC et al: Congenital coronary artery anomalies. Pediatr Clin North Am. 51(5):1273-88, 2004
                                                                          10. Schoenhagen P et al: Noninvasive imaging of coronary arteries: current and future role of multi-detector row CT. Radiology. 232(1):7-17, 2004