Anomalous origin of the left coronary artery from the pulmonary artery with intramural aortic route: Diagnosis and surgical treatment Miguel Barbero-Marcial,

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Presentation transcript:

Anomalous origin of the left coronary artery from the pulmonary artery with intramural aortic route: Diagnosis and surgical treatment Miguel Barbero-Marcial, MD, Carla Tanamati, MD, Edmar Atik, MD, Munir Ebaid, MD, Adib Jatene, MD The Journal of Thoracic and Cardiovascular Surgery Volume 117, Issue 4, Pages 823-825 (April 1999) DOI: 10.1016/S0022-5223(99)70306-5 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 1 Surgical illustration of the aortocoronary window. A, Relationship between the anomalous left coronary artery and the aortic wall. The left coronary artery had an anomalous origin, high on the right pulmonary artery, passed behind the pulmonary trunk, entered the aortic wall running parallel to the aorta, and then was distributed normally to the left ventricle. B, The anterior wall of the ascending aorta was opened wide and the intramural portion of the coronary artery was unroofed intraluminally and its intima attached to the aortic intima with 12 interrupted sutures. Inset shows the final appearance of the created aortocoronary window. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 823-825DOI: (10.1016/S0022-5223(99)70306-5) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 2 Cineangiogram in 1 patient with ALCAPA with an intramural aortic route. A, Trajectory of the anomalous left coronary artery and its relationship with the aorta and pulmonary trunk. B, Right anterior oblique projection showing some indications suggesting the presence of the intramural aortic route. RPA, Right pulmonary artery; PT, pulmonary trunk; RCA, right coronary artery; LCA, left coronary artery; IAR, intramural aortic route; AAo, ascending aorta. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 823-825DOI: (10.1016/S0022-5223(99)70306-5) Copyright © 1999 Mosby, Inc. Terms and Conditions