title: Anomalous origin of the left coronary artery from the right pulmonary artery.
abstract: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare congenital anomaly, one which requires a high index of suspicion in order to be diagnosed promptly and managed accurately. ALCAPA from the right branch pulmonary artery (RPA) is a small subset of ALCAPA in general, with only a few reported cases in the world literature. We report two cases of ALCAPA from the RPA: the first case, an infant, presented in severe cardiac failure requiring preoperative extracorporeal membrane oxygenation (ECMO) for stabilization; and the second, a neonate, presented with severe aortic coarctation (CoA). Both patients underwent successful complete surgical repair using a modified surgical technique, and are doing well in midterm follow-up. We describe our operative technique and review the literature of this rare congenital anomaly.
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio 44106, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Farouk
authors.forename: Kenneth
authors.initials: K
authors.lastname: Zahka
authors.forename: Ernest
authors.initials: E
authors.lastname: Siwik
authors.forename: Alex
authors.initials: A
authors.lastname: Golden
authors.forename: Mohsen
authors.initials: M
authors.lastname: Karimi
authors.forename: Minhaz
authors.initials: M
authors.lastname: Uddin
authors.forename: Hani A
authors.initials: HA
authors.lastname: Hennein
mesh_terms: D000792:Angiography; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods