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Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)

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, w...

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Autores principales: Secinaro, Aurelio, Ntsinjana, Hopewell, Tann, Oliver, Schuler, Pia K, Muthurangu, Vivek, Hughes, Marina, Tsang, Victor, Taylor, Andrew M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123558/
https://www.ncbi.nlm.nih.gov/pubmed/21575211
http://dx.doi.org/10.1186/1532-429X-13-27
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author Secinaro, Aurelio
Ntsinjana, Hopewell
Tann, Oliver
Schuler, Pia K
Muthurangu, Vivek
Hughes, Marina
Tsang, Victor
Taylor, Andrew M
author_facet Secinaro, Aurelio
Ntsinjana, Hopewell
Tann, Oliver
Schuler, Pia K
Muthurangu, Vivek
Hughes, Marina
Tsang, Victor
Taylor, Andrew M
author_sort Secinaro, Aurelio
collection PubMed
description 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 sub-endocardial 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.
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spelling pubmed-31235582011-06-26 Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA) Secinaro, Aurelio Ntsinjana, Hopewell Tann, Oliver Schuler, Pia K Muthurangu, Vivek Hughes, Marina Tsang, Victor Taylor, Andrew M J Cardiovasc Magn Reson Research 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 sub-endocardial 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. BioMed Central 2011-05-16 /pmc/articles/PMC3123558/ /pubmed/21575211 http://dx.doi.org/10.1186/1532-429X-13-27 Text en Copyright ©2011 Secinaro et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 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.
spellingShingle Research
Secinaro, Aurelio
Ntsinjana, Hopewell
Tann, Oliver
Schuler, Pia K
Muthurangu, Vivek
Hughes, Marina
Tsang, Victor
Taylor, Andrew M
Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
title Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
title_full Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
title_fullStr Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
title_full_unstemmed Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
title_short Cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (ALCAPA)
title_sort cardiovascular magnetic resonance findings in repaired anomalous left coronary artery to pulmonary artery connection (alcapa)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123558/
https://www.ncbi.nlm.nih.gov/pubmed/21575211
http://dx.doi.org/10.1186/1532-429X-13-27
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