ABC | Volume 114, Nº4, Suplement, April 2020

Case Report Bu & Zhao Image Diagnosis: ALCAPA Arq Bras Cardiol 2020; 114(4Suppl.1):4-7 1. SchwerzmannM,SalehianO,ElliotT,MerchantN,SiuSC,WebbGD. Images incardiovascularmedicine.Anomalousoriginofthe leftcoronaryartery from the main pulmonary artery in adults: coronary collateralization at its best. Circulation.2004; 110(21):e511-e513. 2. Otsuji Y, Handschumacher MD, Liel-Cohen N, Tanabe H, Jiang L, Schwammenthal E, et al. Mechanism of ischemic mitral regurgitation with segmental leftventriculardysfunction:three-dimensionalechocardiographic studies in models of acute and chronic progressive regurgitation.J Am Coll Cardiol. 2001;37(2):641-8. 3. Quah JX, Hofmeyr L, Haqqani H, Clarke A, Rahman A, Pohlner P,et al. The management of the older adult patient with anomalous left coronary artery from the pulmonary artery syndrome: a presentation of two cases and review of the literature. Congeni Heart Dis. 2014;9(6):E185-E194. 4. Hofmeyr L, Moolman J, Brice E, Weich H. An unusual presentation of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA) in an adult: anterior papillary muscle rupture causing severe mitral regurgitation. Echocardiography. 2009;26(4):474-7. 5. YauJM,SinghR,HalpernEJ,FischmanD.Anomalousoriginofthe leftcoronary artery from the pulmonary artery in adults: a comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman. Clin Cardiol. 2011;34(4):204-10. 6. Vizzuso A, Righi R, Zerbini M, Gamanji S, Cucchi P, Gallo F, et al. An unusual presentation of anomalous left coronary artery from the pulmonary artery (ALCAPA) syndrome in a 70-year-old man: a case report. J Med Case Rep. 2018;12(1):308. 7. Santos AC, Martins D, Anjos R, Saraiva C. Bland-White-Garland syndrome on coronary CT angiography. BMJ Case Rep. 2018 Apr 10. pii bcr-224307 References This is an open-access article distributed under the terms of the Creative Commons Attribution License valvuloplasty/valve replacement and LCA transplantation, they had no symptoms of blood flow steal phenomenon, and myocardial perfusion scintigraphy did not show any ischemic changes. Postoperative echocardiography 7 days after the procedure showed that LCA originates from the aorta with good visualization of the coronary ostia, left atrium and left ventricle became smaller, no MR and ventricular ejection fraction increased to 72%. Hence, their exercise-induced dyspnea and MR were likely due to coronary artery steal phenomenon from their abnormal origin of a coronary artery. This report highlights the essence of increasing the preoperative diagnosis rate in China remote village. For patients with moderate or significant mitral insufficiency without other apparent causes, with left ventricular dilatation and the possible presence of hyperechogenicity of the endocardium and/or papillary muscles, without good visualization of the coronary ostia (or with suspicion of the anomalous origin or dilation of the coronary artery) were submitted to CTA or cardiac angiotomography. Author contributions Conception and design of the research, Acquisition of data, Analysis and interpretation of the data, Statistical analysis, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Bu H, Zhao T; Obtaining financing: Zhao T. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Xiangya Second Hospital under the protocol number XYEYXW-2018-986. All the procedures in this study were in accordancewith the 1975Helsinki Declaration, updated in 2013. 7