Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-27T17:34:03.648Z Has data issue: false hasContentIssue false
  • English
  • Français

Intramural course of an anomalous left coronary artery is not always associated with a slit-like ostium

Published online by Cambridge University Press:  17 January 2023

Lina Paola Montaña-Jimenez ,
Silvana Molossi Open the ORCID record for Silvana Molossi [Opens in a new window] ,
Prakash Masand ,
Jeffrey S. Heinle ,
Ziyad Binsalamah  and
Tam T. Doan Open the ORCID record for Tam T. Doan [Opens in a new window]
Lina Paola Montaña-Jimenez
Affiliation:
Pediatric Cardiology Program, Fundación Valle DE Lili, ICESI, Carrera 98 #18-49, Cali, Valle del Cauca, 760032, Colombia
Silvana Molossi
Affiliation:
Coronary Artery Anomalies Program, Texas Children’s Hospital, 6651 Main Street, MC E1920, Houston, TX 77030, USA The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Baylor College of Medicine, 6651 Main Street, MC E1920, Houston, TX 77030, USA
Prakash Masand
Affiliation:
Coronary Artery Anomalies Program, Texas Children’s Hospital, 6651 Main Street, MC E1920, Houston, TX 77030, USA EB Singleton Department of Pediatric Radiology, Texas Children’s Hospital, Baylor College of Medicine, 6651 Main Street, MC E1920, Houston, TX 77030, USA
Jeffrey S. Heinle
Affiliation:
Coronary Artery Anomalies Program, Texas Children’s Hospital, 6651 Main Street, MC E1920, Houston, TX 77030, USA Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, 6651 Main Street, MC E1920, Houston, TX 77030, USA
Ziyad Binsalamah
Affiliation:
Coronary Artery Anomalies Program, Texas Children’s Hospital, 6651 Main Street, MC E1920, Houston, TX 77030, USA Congenital Heart Surgery, Texas Children’s Hospital, Baylor College of Medicine, 6651 Main Street, MC E1920, Houston, TX 77030, USA
Tam T. Doan*
Affiliation:
Coronary Artery Anomalies Program, Texas Children’s Hospital, 6651 Main Street, MC E1920, Houston, TX 77030, USA The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Baylor College of Medicine, 6651 Main Street, MC E1920, Houston, TX 77030, USA
*
Author for correspondence: Tam T. Doan, MD, 6651 Main Street, MC E1920, Houston, TX 77030, USA. Tel: +1 832 826 5600; Fax: +1 832 826 4290. E-mail: tam.doan@bcm.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Anomalous aortic origin of the left coronary artery from an incorrect aortic sinus has been reported as the second most common causes of sudden cardiac arrest in young athletes. Intramural course of the proximal left coronary artery is considered a high-risk morphology. It is associated with a slit-like ostium and elliptical shape of the proximal artery. In this case, all pre-operative cardiac images demonstrated a round ostium and round luminal shape of the left coronary artery, which suggested no evidence of intramural course. On intraoperative inspection, although the ostium and proximal left coronary artery appeared round, the patient had a long intramural course of the left coronary artery which our surgeons performed a successful unroofing procedure. The post-operative images showed a patent new ostium from the correct aortic sinus. These findings are very unusual and proved that we should not exclude intramural course even in the absence of a slit-like ostium and elliptical shape of the proximal left coronary artery.

Keywords

Anomalous aortic origin of a left coronary arteryintramural courseslit-like ostiumsudden cardiac death
Type
Brief Report
Information
Cardiology in the Young , Volume 33 , Issue 4 , April 2023 , pp. 627 - 629
Check for updates
Copyright
© The Author(s), 2023. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Krishnamurthy, R, Masand, PM, Jadhav, SP, et al. Accuracy of computed tomography angiography and structured reporting of high-risk morphology in anomalous aortic origin of coronary artery: comparison with surgery. Pediatr Radiol. 2021; 51: 1299–1310. DOI 10.1007/s00247-021-05011-0.CrossRefGoogle ScholarPubMed
Giusti, G, Villano, M, Pozzi, M. Unusual intramural course in an anomalous left coronary artery from the opposite coronary sinus. Cardiol Young 2022; 2: 10–12. DOI 10.1017/S1047951122000610.Google Scholar
Van Hare, GF, Ackerman, MJ, Evangelista, J-AK, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 4: congenital heart disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation 2015; 132: e281–e291. DOI 10.1161/CIR.0000000000000240.CrossRefGoogle ScholarPubMed
Frommelt, P, Lopez, L, Dimas, etal VV. Recommendations for multimodality assessment of congenital coronary anomalies: a guide from the American Society of Echocardiography: developed in collaboration with the Society for Cardiovascular Angiography and Interventions. J Am Soc Echocardiogr. 2020; 33: 259–294. DOI 10.1016/j.echo.2019.10.011.CrossRefGoogle ScholarPubMed
Supplementary material: File

Montaña-Jimenez et al. supplementary material

Montaña-Jimenez et al. supplementary material

Download Montaña-Jimenez et al. supplementary material(File)
File 17.4 MB