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Clinics in Surgery

2018 | Volume 3 | Article 18911

ALCAPA in a 49-Year-Old Female Presenting with an Episode of Ventricular Fibrillation

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*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: