CTICasesAnomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) with Proximal Interruption of the Right Pulmonary Artery
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Imaging findings
Chest radiograph showed right-sided volume loss, mediastinal shift, absent right pulmonary artery, and a left-sided aortic arch with fine reticular opacities. Coronary CTA confirmed proximal interruption of the right pulmonary artery and revealed an anomalous left coronary artery arising from the pulmonary artery (ALCAPA), with an otherwise normal right coronary origin and dilated coronary arteries due to steal phenomenon.
Key takeaways
The co-occurrence of ALCAPA and proximal interruption of the pulmonary artery is a very rare combination of congenital anomalies. The elevated pulmonary artery pressures caused by the right pulmonary artery interruption may have reduced the severity of coronary steal from ALCAPA, potentially explaining survival into adulthood. This case illustrates the concept that patients with one congenital abnormality often have others.
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