Anomalous Origin of Left Coronary Artery from Pulmonary Artery (ALCAPA) in an Infant with Bronchiolitis and Dilated Cardiomyopathy

Dilate kardiyomyopatinin en yaygın nedeni viral myokardittir. Bununla birlikte sol koroner arterin pulmoner arterden çıkış anomalisi nadir bir durum olup dilate kardiyomyopatinin etiyolojisinde yüksek şüphe ile irdelenmelidir. Erken cerrahi düzeltme ile koroner arter çıkış anomalisinin prognozu iyidir. Bu bozukluğun farkındalığında olmak hızlı teşhis için önemlidir. Makalede 5 aylık bir süt çocuğunda RSV bronşioliti zemininde gelişen dilate kardiyomopati olgusu bildirilmektedir. RSV infeksiyonu ile viral myokardit geliştiği düşünülen bebekte kesin tanıkoroner arterin pulmoner arterden çıkış anomalisi (ALCAPA) idi. Sol koroner arterin aortaya doğrudan reimplantasyon ameliyatı başarı ile sağlandı. (Güncel Pediatri 2013; 11: 142-5) sol

Bronchiolitis and Dilated Cardiomyopathy Bronşiolit ve Dilate Kardiyomyopatisi Olan Bir Bebekte Sol Koroner Arterin Pulmoner Arterden Çıkış Anomalisi (Alcapa)

The most common cause of dilated cardiomyopathy (CMP) is viral myocarditis. However, anomalous origin of the left coronary artery is a rare condition that should be evaluated with high suspicion in the differential diagnosis of an infant with dilated CMP. With early surgical correction, an anomalous coronary artery origin has a good prognosis. Awareness of this condition is essential for prompt diagnosis. This article reports a 5 months-old infant with dilated cardiomyopathy in the setting of RSV bronchiolitis. Anomalous origin of thecoronary artery from the pulmonary artery (ALCAPA) was the final diagnosis in the infant, who presented as viral myocarditis with RSV infection. She was operated successfully with the direct reimplantation of the coronary artery to the aorta. (Journal of Current Pediatrics 2013; 11: 142-5) left

PDF

___

1. Lipshultz SE, Sleeper LA, Towbin JA, Lowe AM, Orav EJ, Cox GF, et al. The incidence of pediatric cardiomyopathy in two regions of the United States. N Engl J Med 2003;348:1647- 55. 2. Nugent AW, Daubeney PE, Chondros P, Carlin JB, Cheung M, Wilkinson LC, et al. The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med 2003;348:1639-46. 3. Wheeler DS, Kooy NW. A formidable challenge: the diagnosis and treatment of viral myocarditis in children. Crit Care Clin 2003;19:365-91. 4. Canale LS, Monteiro AJ, Rangel I, Wetzel E, Pinto DF, Barbosa RC, et al. Surgical treatment of anomalous coronary artery arising from the pulmonary artery. Interact Cardiovasc Thorac Surg 2009;8:67-9. 5. 6. 7. 8. 9. 10. Ben Ali W, Metton O, Roubertie F, Pouard P, Sidi D, Raisky O, et al. Anomalous origin of the left coronary artery from the pulmonary artery: late results with special attention to the mitral valve. Eur J Cardiothorac Surg 2009;36:244-8; discussion 248-9. Lange R, Vogt M, Hörer J, Cleuziou J, Menzel A, Holper K, et al. Long-term results of repair of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg 2007;83:1463-71. Khongphatthanayothin A, Wong PC, Samara Y, Newth CJ, Wells WJ, Starnes VA, et al. Impact of respiratory syncytial virus infection on surgery for congenital heart disease: postoperative course and outcome. Crit Care Med 1999;27:1974-81. McClard K, Forbess J, Stromberg D, Tortoriello T. Respiratory syncytial viral infection in an infant with unrepaired anomalous left coronary artery from the pulmonary artery. Congenit Heart Dis 2007;2:280-4. Brotherton H, Philip RK. Anomalous left coronary artery from pulmonary artery (ALCAPA) in infants: a 5-year review in a defined birth cohort. Eur J Pediatr 2008;167:43-6. Lipsett J, Cohle SD, Berry PJ, Russell G, Byard RW. Anomalous coronary arteries: a multicenter pediatric autopsy study. Pediatr Pathol 1994;14:287-300.