Arq. Bras. Cardiol. 2020; 114(4 suppl 1): 4-7
Image Diagnosis: An Anomalous Origin of Left Coronary Artery from the Pulmonary Artery
Introduction
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly with a mortality of 90% by 1 year of age without surgical intervention. Nowadays the procedure of choice for correction of ALCAPA depends on the establishment of a dual coronary artery system by direct reimplantation of the anomalous left coronary artery (LCA) into the ascending aorta. However, anatomic variations of the origin of the anomalous LCA often make this aim difficult to achieve, especially in patients undergoing reoperation.
Chronic ischemic mitral regurgitation (MR) develops as a consequence of coronary artery disease in the absence of primary leaflet abnormalities or chordal pathology: ischemic cardiopathy causes remodeling of left ventricular geometry, displacement of papillary muscles, leaflet tethering and annular dilatation, leading to functional mitral insufficiency. The outcome of these patients represents a challenging problem for both cardiologists and cardiac surgeons. In fact, the role of mitral valve surgery (MVS) associated with coronary artery revascularization is still debated.
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