Secinaro, A;
Ntsinjana, H;
Tann, O;
Schuler, PK;
Muthurangu, V;
Hughes, M;
Tsang, V;
(2011)
Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA).
Journal of Cardiovascular Magnetic Resonance
, 13
, Article 27. 10.1186/1532-429X-13-27.
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Abstract
Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare coronary artery anomaly. This study shows the role of cardiovascular magnetic resonance (CMR) in assessing young patients following surgical repair of ALCAPA.Methods: 6 patients, aged 9-21 years, with repaired ALCAPA (2 Tackeuchi method, 4 direct re-implantation) underwent CMR because of clinical suspicion of myocardial ischemia. Imaging used short and long axis cine images (assess ventricular function), late-gadolinium enhancement (LGE) (detect segmental myocardial fibrosis), adenosine stress perfusion (detect reversible ischaemia) and 3D whole-heart imaging (visualize proximal coronary arteries).Results: The left ventricular (LV) global systolic function was preserved in all patients (mean LV ejection fraction = 62.7% +/- 4.23%). The LV volumes were within the normal ranges, (mean indexed LVEDV = 75.4 +/- 3.5 ml/m(2), LVESV = 31.6 +/- 9.4 ml/m(2)). In 1 patient, hypokinesia of the anterior segments was visualized. Five patients showed subendocardial LGE involving the basal, antero-lateral wall and the anterior papillary muscle. Three patients had areas of reversible ischemia. In these 3, 3D whole-heart MRA showed that the proximal course of the left coronary artery was occluded (confirmed with cardiac catheterisation).Conclusions: CMR is a good, non-invasive, radiation-free investigation in the post-surgical evaluation of ALCAPA. In referred patients we show that basal, antero-lateral sub-endocardial myocardial fibrosis is a characteristic finding. Furthermore, stress adenosine CMR perfusion, can identify reversible ischemia in this group, and was indicative of left coronary artery occlusion.
| Type: | Article |
|---|---|
| Title: | Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA) |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/1532-429X-13-27 |
| Publisher version: | http://dx.doi.org/10.1186/1532-429X-13-27 |
| Language: | English |
| Additional information: | © 2011 Secinaro et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | ANGIOGRAPHY, CHILDREN, ORIGIN, DISEASE, THERAPY, INFANTS, HEART |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Childrens Cardiovascular Disease |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1307823 |
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