The value of echocardiography in diagnosis and operation analysis of anomalous origin of left coronary artery from pulmonary artery

doi:10.3877/cma.j.issn.1672-6448.2015.08.011

Abstract

Abstract:

Objective

To investigate the value of echocardiography in diagnosis of anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) , combined with the computed tomography (CT) examination and intraoperative diagnosis.

Methods

The echocardiographic images of 11 patients with ALCAPA confirmed by operation were analyzed, and were compared with CT and intraoperative diagnosis.

Results

The results of echocardiography in 8 cases were consistent with those of CT and surgery. While 3 cases were inconsistent with those of CT and surgery. Two cases were misdiagnosed as right coronary-pulmonary fistula (CPF) and endocardial fibroelastosis (EFE) by echocardiography. One case was misdiagnosed as left coronary artery dilatation, anterior mitral cleft combined with severe regurgitation by echocardiography, and was diagnosed as double anterior descending artery (one was normal and the other originated from pulmonary artery) by CT and surgery.

Conclusions

Echocardiography can diagnose ALCAPA timely and accurately, but there was limitation in the vessels outside of the heart, so echocardiography should be combined with CT and other imaging examination to clarify the coronary artery to assess the surgical indication and prognosis and provide the basis for the doctor's next treatment.

Key words: Echocardiography, Cardiovascular abnormalities, Tomography

Juan Xia, Xiaojing Ma, Juan Guo, Tian Zhang, Yuan Tao. The value of echocardiography in diagnosis and operation analysis of anomalous origin of left coronary artery from pulmonary artery[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(08): 641-645.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2015.08.011

https://chaosheng.cma-cmc.com.cn/EN/Y2015/V12/I08/641

Figures/Tables 3

References 11

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超声检查	例数	手术方式	CT检查	术中检查
ALCAPA	8	左冠状动脉移植（7例）	左冠状动脉主干起源于主肺动脉	术中诊断同CT
?	?	肺动脉内隧道术（1例）	?	?
EFE	1	左冠状动脉移植+冠状动脉肺动脉瘘修补	左冠状动脉主干起源于主肺动脉合并右冠状动脉圆锥支-肺动脉瘘	术中诊断同CT
右CPF	1	左冠状动脉移植术	左冠状动脉起源于肺动脉右后侧壁	术中诊断同CT
左冠状动脉增宽；二尖瓣前叶裂合并重度关闭不全	1	左冠状动脉移植术	2支冠状动脉左前降支，其中一支起源于肺动脉左侧窦，另一支起源左冠状动脉	术中诊断存在2支冠状动脉左前降支，一支起源于肺动脉左侧窦，另一支起源左冠状动脉且合并二尖瓣前叶裂

超声检查	例数	手术方式	CT检查	术中检查
ALCAPA	8	左冠状动脉移植（7例）	左冠状动脉主干起源于主肺动脉	术中诊断同CT
?	?	肺动脉内隧道术（1例）	?	?
EFE	1	左冠状动脉移植+冠状动脉肺动脉瘘修补	左冠状动脉主干起源于主肺动脉合并右冠状动脉圆锥支-肺动脉瘘	术中诊断同CT
右CPF	1	左冠状动脉移植术	左冠状动脉起源于肺动脉右后侧壁	术中诊断同CT
左冠状动脉增宽；二尖瓣前叶裂合并重度关闭不全	1	左冠状动脉移植术	2支冠状动脉左前降支，其中一支起源于肺动脉左侧窦，另一支起源左冠状动脉	术中诊断存在2支冠状动脉左前降支，一支起源于肺动脉左侧窦，另一支起源左冠状动脉且合并二尖瓣前叶裂

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