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Case Reports
. 2021 Apr 8;32(3):497-498.
doi: 10.1093/icvts/ivaa268.

Congenital atresia of the left main coronary artery: management of a 5-year-old child in extremis

Martin Schmiady  1   2 , Oliver Kretschmar  3 , René Prêtre  1   2   4   5 , Hitendu Dave  1   2
Affiliations
Case Reports

Congenital atresia of the left main coronary artery: management of a 5-year-old child in extremis

Martin Schmiady et al. Interact Cardiovasc Thorac Surg. .

Abstract

Atresia of the left main coronary artery is a rare coronary anomaly. We describe the case of a 5-year-old child presenting in emergency in extremis. Clinical findings of haemodynamic collapse, malignant ventricular tachyarrhythmias and severe mitral regurgitation were indicative of a possible ischaemic aetiology. Surgical revascularization of the atretic left main coronary artery segment using an interposition autologous saphenous vein graft was successfully performed.

Keywords: Coronary artery anomalies; Coronary artery bypass grafting; Left main coronary artery atresia; Mitral regurgitation.

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Figures

Figure 1:
Figure 1:
(A) Preoperative angiogram showing a large RCA (arrows). The origin of the left coronary artery fails to contrast on aortic root injection. (B) Preoperative coronary angiogram: large RCA with late retrograde filling of the left coronary artery system through multiple collaterals. Retrograde contrast filling of the left main coronary artery ends up in a blind stump (asterisk). (C) Picture showing the atretic left coronary artery (arrow) with the distal anastomosed vein graft (arrowheads). (D) Autologous great saphenous vein interposition graft (arrows) from aortic sinus to the left anterior descending coronary artery. (E) Selective angiography at 1-year follow-up showing a well revascularized left coronary artery system. (F) Echo Doppler image showing trivial mitral regurgitation at 1 year follow-up. CX: circumflex branch of the left coronary artery; LAD: left anterior descending coronary artery; RCA: right coronary artery.
See this image and copyright information in PMC

References

    1. Kardos A, Babai A, Rudas L, Gaál T, Horváth T, Tálosi L. et al. Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a Central European population. Cathet Cardiovasc Diagn 1997;42:270–5. - PubMed
    1. Angelini P, Villason S, Chan AV, Diez JG.. Humans normal and anomalous coronary arteries in humans. In: Coronary Artery Anomalies: A Comprehensive Approach. Philadelphia, PA: Lippincott Williams and Wilkins, 1999.
    1. Uysal F, Bostan O, Semizel E, Signak I, Asut E, Ergun C.. Congenital anomalies of coronary arteries in children: the evaluation of 22 patients. Pediatr Cardiol 2014;35:778–84. - PubMed
    1. Musiani A, Cernigliaro C, Sansa M, Maselli D, De Gasperis C.. Left main coronary artery atresia: literature review and therapeutical considerations. Eur J Cardiothorac Surg 1997;11:505–14. - PubMed
    1. Gebauer R, Cerny S, Vojtovic P, Tax P.. Congenital atresia of the left coronary artery—myocardial revascularization in two children. Interact CardioVasc Thorac Surg 2008;7:1174–5. - PubMed

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