Murat KERKÜTLÜOĞLU, Enes ÇELİK, Bayram ÖZTÜRK, Hakan GÜNEŞ

66 Yaşında Kadın Hastada Yeni Tanı ALCAPA Sendromu

Sol koroner arterin pulmoner arterden (ALCAPA) anormal kökeni, nadir görülen doğuştan kalp anomalisidir. Genellikle klinik seyir; ileri sol kalp yetmezliği ve yaşamın ilk aylarında ortaya çıkan mitral kapak yetersizliğidir. Bununla birlikte, bazı durumlarda sağ koroner arterden oluşan kollateraller miyokard perfüzyonu için yeterlidir. ALCAPA'lı hastalarda aritmi veya erişkin yaşamda ani kalp ölümü ilk klinik başvuru olabilir. Göğüs ağrısı ve çarpıntı şikayetleri ile acil servise başvuran ve sol koroner arterde anormal köken saptanan 66 yaşında kadın hastayı sunmaktayız.

Anahtar Kelimeler:

L-ALCAPA, koroner anomali, kardiyak arrest, yetişkin

New Diagnosis ALCAPA Syndrome in a 66-Year-Old Woman

Abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart anomaly. Usually the clinical course; advanced left heart failure and mitral valve insufficiency that occurs in the first months of life. However, in some cases collaterals consisting of the right coronary artery are sufficient for myocardial perfusion. Arrhythmia or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We present a 66-year-old female patient who was admitted to the emergency department with complaints of chest pain and palpitations and was found to have an abnormal origin in the left coronary artery.

Keywords:

L-ALCAPA, coronary anomaly, cardiac arrest, adult,

PDF

___

1. Rodriguez-Gonzalez M, Tirado AM, Hosseinpour R, Soto JS. Anomalous origin of the left coronary artery from the pulmonary artery diagnoses and surgical results in 12 pediatric patients. Tex Heart Inst J. 2015;42(4):350–356.
2. Birk E, Stamler A, Katz J, Berant M, Dagan O, Matitiau A, et al. Anomalous origin of the left coronary artery from the pulmonary artery diagnosis and postoperative follow up. Isr Med Assoc J. 2000;2(2):111–114.
3. Karr SS, Parness IA, Spevak PJ. van der Velde ME.Colan SD.Sanders SP Diagnosis of anomalous left coronary artery by Doppler color flow mapping distinction from other causes of dilated cardiomyopathy. J Am Coll Cardiol. 1992;19(6):1271–1275.
4. Dilaveris, P, Koutagiar, I, Alexopoulos, N. Secondary prevention of sudden cardiac death in a 65 year untreated alcapa patient. Int J Cardiol 2014; 176: 73–74.
5. Oncel, G, Oncel, D. Anomalous origin of the left coronary artery from the pulmonary artery: diagnosis with CT angiography. J Clin Imaging Sci 2013; 3: 4.
6. Zheng JY, Han L, Ding WH, Jin M, Zhang GZ, Xiao YY, et al. Clinical features and long-term prognosis of patients with anomalous origin of the left coronary artery from the pulmonary artery. Chin Med J (Engl) 2010;123(20):2888–2894.
7. Ceylan Ö, Örün UA, Koç M, Özgür S, Dogan V, Karademir S, et al. Anomalous coronary artery originating from the pulmonary artery a report of four cases. Türk Gögüs Kalp Damar Cerrahisi Dergisi. 2013;21:122–126.
8. P. E. Kaunitz, “Origin of left coronary artery from the pulmonary artery: review of the literature and report of two cases,” American Heart Journal, vol. 33, no. 2, pp. 182–206, 1947.
9. G. Dahle, A. Fiane, and H. Lindberg, “ALCAPA, a possible reason for mitral insufficiency and heart failure in young patients,” Scandinavian Cardiovascular Journal, vol. 41, no. 1, pp. 51–58, 2007.
10. B. Shivalkar, M. Borgers, W. Daenen, M. Gewillig, W. Flameng, “ALCAPA syndrome: an example of chronic myocardial hypoperfusion?” Journal of the American College of Cardiology, vol. 23, no. 3, pp. 772–778, 1994.
11. Alsoufi B, Sallehuddin A, Bulbul Z, Joufan M, Khouqeer F, Canver CC, et al. Surgical strategy to establish a dual-coronary system for the management of anomalous left coronary artery origin from the pulmonary artery. Ann Thorac Surg. 2008;86(1):170–176.
12. Vouhé PR, Tamisier D, Sidi D, Vernant F, Mauriat P, Pouard P, et al. Anomalous left coronary artery from the pulmonary artery results of isolated aortic reimplantation. Ann Thorac Surg. 1992;54(4):621–626.
13. Huddleston CB, Balzer DT, Mendeloff EN. Repair of anomalous left main coronary artery arising from the pulmonary artery in infants long-term impact on the mitral valve. Ann Thorac Surg. 2001;71(6):1985–1988.
14. Yau JM, Singh R, Halpern EJ, Fischman D. Anomalous origin of the left coronary artery from the pulmonary artery in adults: a comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman. Clin Cardiol. 2011 Apr;34(4):204-10.