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Remedy Publications LLC., | http://clinicsinsurgery.com/ Clinics in Surgery 2018 | Volume 3 | Article 1891 1 ALCAPA in a 49-Year-Old Female Presenting with an Episode of Ventricular Fibrillation OPEN ACCESS *Correspondence: Sebastian Michel, Department of Cardiac Surgery, Klinikum der Universität München, Ludwig- Maximilian-University Munich, Marchioninistrasse 15, 81377 München, Germany, Tel: +49-89-4400-0; E-mail: [email protected] muenchen.de Received Date: 11 Jan 2018 Accepted Date: 20 Jan 2018 Published Date: 24 Jan 2018 Citation: Michel S, Hagl C, Reichelt A, Naebauer M, Schramm R. ALCAPA in a 49-Year- Old Female Presenting with an Episode of Ventricular Fibrillation. Clin Surg. 2018; 3: 1891. Copyright © 2018 Sebastian Michel. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Clinical Image Published: 24 Jan, 2018 Sebastian Michel 1 *, Christian Hagl 1 , Angela Reichelt 2 , Michael Naebauer 3 and Rene Schramm 1 1 Department of Cardiac Surgery, Ludwig Maximilian University Munich, Germany 2 Department of Radiology, Ludwig Maximilian University Munich, Germany 3 Department of Cardiology, Ludwig Maximilian University Munich, Germany Keywords Coronary anomaly; ALCAPA; CABG Clinical Image A 49-year-old female patient presented with an episode of ventricular fibrillation. ALCAPA (anomalous leſt coronary artery from the pulmonary artery) was diagnosed and treated with coronary artery bypass graſting. In ALCAPA, coronary ischemia occurs due to a steal phenomenon: collaterals from the right coronary artery fill-up the leſt anterior descending artery (LAD) and the circumflex artery in a retrograde fashion because of the lower pressure in the pulmonary artery. Preoperatively, the monstrous right coronary artery filled the leſt system in a retrograde fashion: CT- scan (1a), angiogram (1b) and intraoperatively (2a). A saphenous vein graſt (SVG) was anastomosed to the LAD (2b), and the aberrant ostium in the pulmonary artery was closed, so that the coronary flow in the leſt system became antegrade. Figure 1:
Transcript of Clinics in Surgery Clinical Imageclinicsinsurgery.com/pdfs_folder/cis-v3-id1891.pdfE-mail:...
Remedy Publications LLC., | http://clinicsinsurgery.com/
Clinics in Surgery
2018 | Volume 3 | Article 18911
ALCAPA in a 49-Year-Old Female Presenting with an Episode of Ventricular Fibrillation
OPEN ACCESS
*Correspondence:Sebastian Michel, Department
of Cardiac Surgery, Klinikum der Universität München, Ludwig-Maximilian-University Munich,
Marchioninistrasse 15, 81377 München, Germany, Tel: +49-89-4400-0;
E-mail: [email protected]
Received Date: 11 Jan 2018Accepted Date: 20 Jan 2018Published Date: 24 Jan 2018
Citation: Michel S, Hagl C, Reichelt A, Naebauer M, Schramm R. ALCAPA in a 49-Year-
Old Female Presenting with an Episode of Ventricular Fibrillation. Clin Surg.
2018; 3: 1891.
Copyright © 2018 Sebastian Michel. This is an open access
article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the original work is properly
cited.
Clinical ImagePublished: 24 Jan, 2018
Sebastian Michel1*, Christian Hagl1, Angela Reichelt2, Michael Naebauer3 and Rene Schramm1
1Department of Cardiac Surgery, Ludwig Maximilian University Munich, Germany
2Department of Radiology, Ludwig Maximilian University Munich, Germany
3Department of Cardiology, Ludwig Maximilian University Munich, Germany
KeywordsCoronary anomaly; ALCAPA; CABG
Clinical ImageA 49-year-old female patient presented with an episode of ventricular fibrillation. ALCAPA
(anomalous left coronary artery from the pulmonary artery) was diagnosed and treated with coronary artery bypass grafting. In ALCAPA, coronary ischemia occurs due to a steal phenomenon: collaterals from the right coronary artery fill-up the left anterior descending artery (LAD) and the circumflex artery in a retrograde fashion because of the lower pressure in the pulmonary artery. Preoperatively, the monstrous right coronary artery filled the left system in a retrograde fashion: CT-scan (1a), angiogram (1b) and intraoperatively (2a). A saphenous vein graft (SVG) was anastomosed to the LAD (2b), and the aberrant ostium in the pulmonary artery was closed, so that the coronary flow in the left system became antegrade.
Figure 1:
