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Register a new userCase Report: The Surgical Repaire of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery (Alcapa) in 5 Years Old Little Girl
الإصلاح الجراحي للمنشأ الشاذ للشريان الإكليلي الأيسر من الشريان الرئوي لدى طفلة بعمر خمس سنوات
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Damascus University ورقة بحثية
Publication date
2010
fields
Medicine
and research's language is
العربية
Authors
أحمد تكريتي( باحث )
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Shamra Editor
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يعد شذوذ منشأ الشريان الإكليلي الأيسر من الشريان الرئوي تشوهاً ولادياً نادراً. غالباً ما يتظاهر في مرحلة الرضاعة بأعراض نقص التروية القلبية أو قصور القلب، و قد يشتبه مع حالات شائعة في الطفولة مثل القولنج المعوي أو القلس المريئي أو التهاب القصيبات. يكون الإنذار جيداً في حال الإصلاح الجراحي الباكر. نقدم في هذا التقرير حالة غير اعتيادية لطفلة بعمر 5 سنوات لديها شذوذ في منشأ الشريان الإكليلي الأيسر من الشريان الرئوي تظاهر لديها بألم صدري و زلة تنفسية و خفقان تُثار بالجهد. أظهر التصوير بالإيكو القلبي عبر جدار الصدر و التصوير الشرياني الإكليلي المنشأ الشاذ للشريان الإكليلي الأيسر مع وجود قصور في الصمام التاجي. خضعت الطفلة لتكنيك جراحي ناجح تضمن استخدام الشريان الصدري (الثديي) الباطن في إعادة تروية الشريان الإكليلي الأيسر الرئيسي، و يعد هذا الإجراء الأول من نوعه لدى الأطفال. تم بذلك الحصول على نتائج جراحية ممتازة و تخرجت المريضة في المشفى دون شكايات.
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It presents predominantly in infancy with features of myocardial ischemia or cardiac failure and may be mistaken for common pediatric conditions such as colic, reflux or bronchiolitis. With early surgical correction the prognosis is good. In this report we present unusual case of a 5-year-old female with an anomalous left coronary artery arising from the pulmonary artery (ALCAPA) presenting with chest pain,dyspnea and palpitation during physical exertion.Trans-thoracic echocardiography and coronary angiography revealed an anomalous origin of the left coronary artery with mitral regurgitation . She subsequently underwent successful surgical technique where the left internal thoracic(mammary) artery was used to revascularise the left main coronary artery which is considered as the first unique procedure in children. Excellent surgical results were obtained and the patient was discharged from the hospital without complaints.
References used
Stark,de Leval,Tsang. Congenital Coronary Artery Fistula and Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery,. Surgery for congenital heart defects.3rd edition.John Wiley and Sons.2006.p612- 617
Anderson,Cook,Wicox.ANOMALIES OF THE CORONARY ARTERIES.Surgical anatomy of the heart.3rd edition,Cambridge university press 2004,p298-304
Fierens C, Budts W, Denef B, et al. A 72-year-old woman with ALCAPA. Heart 2000;83:E2
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