Anomalous left coronary artery from pulmonary artery (ALCAPA) is a rare congenital heart defect characterized by cardiomegaly and left ventricular dysfunction. The definite treatment for ALCAPA is re-implantation of the left coronary artery (LCA). To the best of our knowledge there is no data regarding the extent of the myocardial damage in these patients. Therefore the aim of the current study was to evaluate by CMRI the myocardial function and damage (scar) in a series of patients who underwent re-implantation surgery for ALCAPA.
We retrospectively reviewed the medical charts and imaging studies of 9 children who were diagnosed with ALCAPA between 2001 and 2011. Five of whom underwent follow-up CMRI after the operation that included balanced turbo flash echo (BTFE) sequences for left ventricular function, as well asphase-sensitive inverse recovery (PSIR) sequences for delayed enhancement (DE). In addition, dedicated BTFE planes and 3D whole heart BTFE sequences were utilized to acquire images of the anastomoses sites. .
Results:
All the anastomoses were patent.
Conclusion: In this small group of ALCAPA patients, DE in the territory of the LCA is common. Apparently the pre operation, as well as post operation LV function among patients with DE, are lower than among patients without DE. We plan, in collaboration with several medical centers, to enlarge the current database in order to clarify whether the phenomenon of DE in ALCAPA patients is widespread and whether routine CMRI of these patients can be useful for improved risk stratification.
