Hughes, Marina L

Muthurangu, Vivek

Ntsinjana, Hopewell

Secinaro, Aurelio

Tann, Oliver

Taylor, Andrew M

Tsang, Victor

Journal of Cardiovascular Magnetic Resonance

English

PubMed

Aurelio Secinaro

Hopewell Ntsinjana

Vivek Muthurangu

Oliver Tann

Marina L Hughes

Victor Tsang

Andrew M Taylor

Springer - Publisher Connector

Cardiovascular magnetic resonance assessment in previously repaired ALCAPA

Crossref

POSTER PRESENTATION Open Access
Cardiovascular magnetic resonance assessment in
previously repaired ALCAPA
Aurelio Secinaro*, Hopewell Ntsinjana, Vivek Muthurangu, Oliver Tann, Marina L Hughes, Victor Tsang,
Andrew M Taylor
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Introduction
Anomalous origin of the left coronary artery from the
pulmonary artery (ALCAPA) is a rare coronary artery
anomaly.
Purpose: The aim of this study is to show the role of
cardiovascular magnetic resonance (CMR) in assessing
these patients.
Methods
6 patients with repaired ALCAPA (2 Tackeuchi, 4 direct
re-implantation) underwent CMR to assess clinical sus-
picion of myocardial ischemia - short axis and long axis
cine images (assess ventricular function), late-gadoli-
nium enhancement (detect myocardial fibrosis), adeno-
sine stress perfusion scan (detection of reversible
ischaemia) and 3D whole-heart imaging (visualization of
proximal coronary arteries).
Results
The LV function was preserved in all patients (mean
LVEF= 62.7% ± 4.23%). The LV volumes were within
the normal ranges LV (mean indexed LVEDV=75.4 ml
± 3.5, mean LVESV= 31.6 ml ± 9.37) In one patient,
hypokinesia of the anterior segments was visualized. 5 of
the 6 patients showed sub-endocardial late gadolinium
enhancement involving the antero-lateral wall and the
anterior papillary muscle. 4 of the 6 patients presented
areas of inducible ischemia, reversible at rest. In 3 of the
Great Ormond Street Hospital for Children - Institute of Child Health,
London, UK
Figure 1 The charachteristic LGE in our repaired ALCAPA population.
Secinaro et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P192
http://jcmr-online.com/content/13/S1/P192
© 2011 Secinaro et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
6 patients the proximal course of the left coronary
artery wasn’t clearly visualized. In these patients, proxi-
mal the LCA obstruction was confirmed during invasive
coronary angiography.
Conclusions
CMR is a good, non-invasive, radiation-free investigation
in the post-surgical evaluation of ALCAPA. We show
that antero-lateral sub-endocardial myocardial fibrosis is
a characteristic finding. Furthermore, stress adensoine
CMR perfusion, can identify reversible ischaemia in this
group. Such imaging may be a promising tool in the
future clinical decision -making.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-P192
Cite this article as: Secinaro et al.: Cardiovascular magnetic resonance
assessment in previously repaired ALCAPA. Journal of Cardiovascular
Magnetic Resonance 2011 13(Suppl 1):P192.
Figure 2 Perfusion defect in repaired ALCAPA.
Figure 3 3D whole-heart imaging of ALCAPA repair compared with invasive coronary angiography(Tackeuchi technique).
Secinaro et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P192
http://jcmr-online.com/content/13/S1/P192
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Cardiovascular magnetic resonance assessment in previously repaired ALCAPA

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