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Anomalous Anatomy

LCA off PA (ALCAPA)
ALCAPA syndrome is a rare congenital anomaly described as an anomalous origin of the left coronary artery from the pulmonary artery. ALCAPA can occur in children or adults, and in children it is said that 90% experience a myocardial infarct and die within the 1st year of life with out intervention. The 10% of patients who live past infancy develop significant circulation from RCA to LCA.

In adult patients the LCA arises from left inferolateral aspect of the main pulmonary artery. The RCA and LCA may appear dilated and tortuous with dilated intercoronary collateral arteries and left ventricular hypertrophy or dilatation may occur.

Left main coronary artery arising off the main pulmonary trunk.

CTA shows the left main coronary artery arising off the main pulmonary trunk.

CTA shows the left main coronary artery arising off the main pulmonary trunk, with prominent right coronary artery.

CTA shows the left main coronary artery arising off the main pulmonary trunk.

CTA shows prominent right coronary artery.