An Unusual Combination of an Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) and a Right Coronary Artery System with Two Separate Ostia from the Aorta in an Adult

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 27; no. 1; pp. E13 - E17
• Main Authors: Kats, Yuliya, Solanki, Pallavi, Waller, Alfonso H., Maldjian, Pierre D., Hamirani, Kamran, Tsai, Steve C., Dhruva, Vivek, Klapholz, Marc, Saric, Muhamed
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.01.2010
• Subjects: Abnormalities, Multiple - diagnostic imaging; Adult; anomalous coronary artery; Aorta - abnormalities; Aorta - diagnostic imaging; computed tomography; congenital heart disease; Coronary Vessel Anomalies - diagnostic imaging; Coronary Vessels - diagnostic imaging; Echocardiography; Humans; Male; myocardial ischemia; Pulmonary Artery - abnormalities; Pulmonary Artery - diagnostic imaging
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/j.1540-8175.2009.01040.x

We describe a patient with an infrequent combination of variants in both the right and the left coronary arterial ostia, namely a combination of two separate right coronary artery (RCA) ostia from the aorta, and an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). To our knowledge, such a combination has not been previously reported. Based on published statistics for individual variants, such a combination is expected to occur approximately once for every 500,000 to one million live births. ALCAPA and dual RCA anatomy was characterized in our patient by echocardiography, conventional angiography, and multidetector computed tomography before and after Takeuchi repair. (Echocardiography 2010;27:E13‐E17) A simultaneous occurrence of anomalies in the origin of both the right and the left coronary arteries is uncommon. We report a case of a young woman with two separate origins of the right coronary artery from the aorta and an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). To our knowledge, such a combination has not been previously reported and is expected to occur approximately once for every 500,000 to one million live births. ALCAPA and dual right coronary artery anatomy was characterized in our patient by echocardiography, conventional angiography and multidetector computed tomography before and after Takeuchi repair.