{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T02:03:00Z","timestamp":1780970580581,"version":"3.54.1"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T00:00:00Z","timestamp":1579651200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951119003299_as1\" sec-type=\"other\"><jats:title>Background:<\/jats:title><jats:p>Anomalous left coronary artery from the pulmonary artery is a rare congenital heart disease (CHD) with diverse clinical presentations despite the same anatomy. Factors determining this heterogeneous presentation are not well understood.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951119003299_as2\" sec-type=\"other\"><jats:title>Method and Results:<\/jats:title><jats:p>We retrospectively investigated 14 patients (12 females) who underwent surgical repair of anomalous left coronary artery from the pulmonary artery. These patients were divided into three groups based upon the severity of initial presentation: (1) severe, life-threatening condition (n = 5), (2) mild-to-moderate distress (n = 6), and (3) asymptomatic (n = 3). All patients presented with left ventricular dilation and retrograde flow in left coronary artery by echocardiogram. Eight patients in (1) and (2) presented with severe left ventricular dysfunction. All but one showed abnormal ECG consistent with myocardial ischemia or infarction. Asymptomatic patients had preserved left ventricular systolic function despite ischemic findings on ECG. In 13 patients after surgical repair, all but one normalised left ventricular geometry and systolic function, suggesting nearly full myocardial recovery upon improvement of myocardial perfusion; 8 patients had residual echogenic papillary muscle with variable degree of mitral regurgitation.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951119003299_as3\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Evidence of myocardial ischemic injury was present in all patients with anomalous left coronary artery from the pulmonary artery regardless of their initial presentation. Retrograde flow in left coronary artery, implying collateral vessel development from right coronary artery to left coronary artery, was noted in all patients, yet only few patients had preserved systolic function at the time of diagnosis. The balance between effective myocardial perfusion and a deleterious fistulous flow provided by these collaterals and the simultaneous haemodynamic status are what determine the clinical diversity of anomalous left coronary artery from the pulmonary artery.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951119003299","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T04:28:39Z","timestamp":1579667319000},"page":"362-368","source":"Crossref","is-referenced-by-count":3,"title":["Effective myocardial perfusion and concomitant haemodynamic status determine the clinical diversity of anomalous left coronary artery from the pulmonary artery"],"prefix":"10.1017","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3497-5581","authenticated-orcid":false,"given":"Amr A.","family":"Matoq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8110-1388","authenticated-orcid":false,"given":"Takeshi","family":"Tsuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,1,22]]},"reference":[{"key":"S1047951119003299_ref5","first-page":"26","article-title":"Two cases of an abnormal coronary artery of the heart arising from the pulmonary artery: with some remarks upon the effect of this anomaly in producing cirsoid dilatation of the vessels","volume":"20","author":"Brooks","year":"1885","journal-title":"J Anat Physiol"},{"key":"S1047951119003299_ref25","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1406508111"},{"key":"S1047951119003299_ref18","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.75.1.115"},{"key":"S1047951119003299_ref24","doi-asserted-by":"publisher","DOI":"10.1172\/JCI72181"},{"key":"S1047951119003299_ref20","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2013.207"},{"key":"S1047951119003299_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-0916-4"},{"key":"S1047951119003299_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000511"},{"key":"S1047951119003299_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/2048872614562969"},{"key":"S1047951119003299_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht195"},{"key":"S1047951119003299_ref31","first-page":"H421","article-title":"Myocardial oxygen consumption: the role of wall force and shortening","volume":"233","author":"Weber","year":"1977","journal-title":"Am J Physiol"},{"key":"S1047951119003299_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.11.020"},{"key":"S1047951119003299_ref27","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000250365.25480.c5"},{"key":"S1047951119003299_ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-1038-8"},{"key":"S1047951119003299_ref10","doi-asserted-by":"publisher","DOI":"10.14503\/THIJ-13-3849"},{"key":"S1047951119003299_ref29","doi-asserted-by":"publisher","DOI":"10.1177\/021849230501300106"},{"key":"S1047951119003299_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)03633-0"},{"key":"S1047951119003299_ref2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.21.2.149"},{"key":"S1047951119003299_ref3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.51.6.976"},{"key":"S1047951119003299_ref4","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.38.2.403"},{"key":"S1047951119003299_ref11","first-page":"2888","article-title":"Clinical features and long-term prognosis of patients with anomalous origin of the left coronary artery from the pulmonary artery","volume":"123","author":"Zheng","year":"2010","journal-title":"Chin Med J"},{"key":"S1047951119003299_ref12","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2017.08.018"},{"key":"S1047951119003299_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.02.082"},{"key":"S1047951119003299_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-007-0423-1"},{"key":"S1047951119003299_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00344-8"},{"key":"S1047951119003299_ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00395-008-0760-x"},{"key":"S1047951119003299_ref6","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20848"},{"key":"S1047951119003299_ref23","doi-asserted-by":"publisher","DOI":"10.1038\/386671a0"},{"key":"S1047951119003299_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.04.015"},{"key":"S1047951119003299_ref28","first-page":"pii: A5125","article-title":"Diagnosis and prognosis of anomalous origin of the left coronary artery from the pulmonary artery","volume":"62","author":"Holst","year":"2015","journal-title":"Danish Med J"},{"key":"S1047951119003299_ref30","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-8-139"},{"key":"S1047951119003299_ref32","first-page":"2333","article-title":"Surgical outcomes of anomalous origin of the left coronary artery from the pulmonary artery in children: an echocardiography follow-up","volume":"130","author":"Gao","year":"2017","journal-title":"Chinese Med J"},{"key":"S1047951119003299_ref16","doi-asserted-by":"publisher","DOI":"10.4236\/ojped.2012.21013"},{"key":"S1047951119003299_ref33","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.60.6.522"},{"key":"S1047951119003299_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(00)00206-6"},{"key":"S1047951119003299_ref37","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X113099990005"},{"key":"S1047951119003299_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1982.tb55207.x"},{"key":"S1047951119003299_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(33)90140-4"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951119003299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T04:43:32Z","timestamp":1583988212000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951119003299\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,22]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["S1047951119003299"],"URL":"https:\/\/doi.org\/10.1017\/s1047951119003299","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,22]]}}}