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Right arrow Lung - transplantation

Ann Thorac Surg 2003;75:282-284
© 2003 The Society of Thoracic Surgeons

Case report

Heart transplant for anomalous origin of left coronary artery from pulmonary artery

Kiron K.S. Nair, MDa, Lawrence S. Zisman, MDa, Ellis Lader, MDa, Aneta Dimova, MDa, Charles C. Canver, MD*a

a Heart Institute, Albany Medical College, Albany, New York, USA

Accepted for publication July 31, 2002.

* Address reprint requests to Dr Canver, Heart Institute, Albany Medical College, 47 New Scotland Ave, Mail Code 55, Albany, NY 12208-3479, USA
e-mail: canverc{at}mail.amc.edu

Anomalous origin of the left coronary artery from the pulmonary artery is a congenital coronary artery malformation most commonly present in infancy. A variety of surgical procedures have been described to achieve physiological correction of the coronary flow abnormalities. These techniques are effective as long as there is potential for myocardial recovery. However the sequelae of chronic myocardial ischemia that characterize this entity often irreversibly damage the heart and preclude correction and palliation of the native anomaly. In this type of setting, heart transplantation is a realistic option. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) occasionally presents in adulthood. Anatomic repair with a two coronary artery system may not be optimal in patients presenting with ischemic cardiomyopathy. We report an adult patient with platelet factor 4 (PF4) antibodies who underwent orthotopic heart transplantation (OHT) for ALCAPA.




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