Alcapa
ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery) is a rare congenital heart defect in which the left coronary artery (LCA) originates from the pulmonary artery instead of the aorta. This condition can lead to severe myocardial ischemia and heart failure if not treated promptly.
Pathophysiology[edit | edit source]
In a normal heart, the left coronary artery arises from the aorta, supplying oxygen-rich blood to the heart muscle. In ALCAPA, the LCA originates from the pulmonary artery, which carries oxygen-poor blood. This results in inadequate oxygen supply to the myocardium, leading to myocardial ischemia, infarction, and potentially heart failure.
Clinical Presentation[edit | edit source]
Symptoms of ALCAPA typically present in infancy, often within the first few months of life. Common symptoms include:
In some cases, ALCAPA may remain asymptomatic until later in childhood or adulthood, where it may present as sudden cardiac arrest or heart failure.
Diagnosis[edit | edit source]
Diagnosis of ALCAPA is typically made through a combination of clinical evaluation and imaging studies. Key diagnostic tools include:
Treatment[edit | edit source]
The primary treatment for ALCAPA is surgical correction. The most common surgical procedures include:
- Direct reimplantation of the anomalous coronary artery into the aorta
- Coronary artery bypass grafting (CABG)
- Creation of an intrapulmonary tunnel (Takeuchi procedure)
Early surgical intervention is crucial to prevent irreversible myocardial damage and improve long-term outcomes.
Prognosis[edit | edit source]
With timely surgical intervention, the prognosis for individuals with ALCAPA is generally favorable. Postoperative follow-up is essential to monitor cardiac function and detect any potential complications.
Related Pages[edit | edit source]
- Congenital heart defect
- Coronary artery
- Pulmonary artery
- Aorta
- Myocardial ischemia
- Heart failure
- Echocardiography
- Cardiac catheterization
- Cardiac MRI
- CT angiography
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Contributors: Prab R. Tumpati, MD
