Anomalous origin of the left coronary artery from the right pulmonary artery presenting following relief of left heart obstruction: a distinct and predictable clinico-pathological syndrome.
BACKGROUND
Pre-operative recognition of significant abnormalities of the coronary arteries is important in a variety of congenital cardiac conditions. Failure to diagnose anomalous origin of the coronary artery from the pulmonary artery during repair of other anomalies is important because reduction in pulmonary artery pressure will reduce myocardial perfusion pressure.


METHODS
We report two cases of the rare association of anomalous origin of the left coronary artery from the right pulmonary artery, aortic coarctation, and mitral stenosis.


CONCLUSIONS
Definitive imaging of coronary artery anatomy by echocardiography or other modalities should form a routine part of diagnostic assessment in all congenital heart disease patients but particularly those with left heart obstruction.
Morgan
Gareth
G
Hospital for Sick Children--Labatt Family Heart Centre, Toronto Canada. hotmorgan@doctors.net.uk
Caldarone
Christopher
C
Anderson
Robert
R
Chaturvedi
Rajiv
R
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001017:Aortic Coarctation / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D018618:Echocardiography, Doppler, Color; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D008946:Mitral Valve Stenosis / Q000151:congenital* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D011652:Pulmonary Circulation; D016896:Treatment Outcome