Objective: To summarize the echocardiographic features of anomalous left coronary artery from the pulmonary artery (ALCAPA).
Methods: A study was performed on 10 patients with ALCAPA retrospectively and the result was compared with coronary angiography to summarize its echocardiographic features.
Results: Of the 10 patients with ALCAPA, there were 3 cases of infantile type and 7 cases of adult type. Left ventricular cavity was enlarged and the anterior and lateral wall motion was reduced in all patients with the infantile type ALCAPA. The trunk and branch of the right coronary artery was enlarged in patients with the adult type, meanwhile the diastolic blood flow signal could be detected in inter-ventricular septum and in the area supplied by the left anterior descending coronary artery. The trunk of the left coronary artery originated from the pulmonary artery in 7 patients, the left circumflex artery originated from the pulmonary artery in another 3 patients. Diastolic blood flow signal could be detected by the Doppler echocardiogram in the pulmonary artery in all patients. One patient was misdiagnosed as coronary artery fistula, and correct diagnosis was made by the coronary angiography. In 1 patient, echocardiography examination suggested that the left coronary artery was originated from left coronary aortic sinus and angiography results showed that the left coronary artery was originated from the right posterior sinus of the pulmonary artery. Eight ALCAPA patients suffered from other cardiovascular abnormalities, including atrial septum defect, ventricular septal defect and non-compaction of ventricular myocardium.
Conclusions: Abnormal connection of the left coronary artery with pulmonary artery and diastolic blood flow are typical echocardiographic findings in patients with ALCAPA. Coronary angiography serves as an important tool for the correct diagnosis of ALCAPA.