{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:54:27Z","timestamp":1754160867430,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Association of anomalous origin of a coronary artery arising from pulmonary artery (PA) with other congenital heart defects, such as ventricular septal defects (VSDs), is uncommon. In such cases, coronary anomalies may be overlooked and underdiagnosed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report a case of late diagnosis of a circumflex coronary artery arising from the right PA, 25 years after VSD-closure during infancy with a complicated post-operative course with severe left ventricular dysfunction. Eventually being discharged, she remained asymptomatic until reaching adulthood, when she developed atypical chest pain during moderate exertion initially with no further investigation being performed. The patient further developed palpitations and underwent a CT-scan, showing an anomalous circumflex artery arising from the right PA. Surgical circumflex artery re-implantation was performed and the symptoms have resolved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case report highlights the unique pathophysiology of coronary artery steal when arising from the PA. Severe ventricular dysfunction, frequently occurring post-operatively after VSD-closure is usually related to increased afterload. However, other causes should not be neglected especially if function does not improve. Long-term follow-up is therefore mandatory for patients diagnosed with congenital heart disease, even after supposedly simple defects.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf325","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T10:36:22Z","timestamp":1752143782000},"source":"Crossref","is-referenced-by-count":0,"title":["Coronary steal from an anomalous circumflex artery diagnosed 25 years after ventricular septal defect closure: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5385-673X","authenticated-orcid":false,"given":"Bastien","family":"Provost","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Diseases, Reference Center for Complex Congenital Cardiac Disease M3C, Marie Lannelongue Hospital , 133 Avenue de la R\u00e9sistance, Plessis-Robinson 92350 ,","place":["France"]},{"name":"Division of Cardiovascular Surgery, The Labatt Family Heart Center, The Hospital of Sick Children , Toronto, ON M5G 1X8 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktoria","family":"Weixler","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, The Labatt Family Heart Center, The Hospital of Sick Children , Toronto, ON M5G 1X8 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Fournier","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Diseases, Reference Center for Complex Congenital Cardiac Disease M3C, Marie Lannelongue Hospital , 133 Avenue de la R\u00e9sistance, Plessis-Robinson 92350 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelaide","family":"Richard","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, H\u00f4pital Priv\u00e9 de La Louvi\u00e8re , Lille 59800 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-6610","authenticated-orcid":false,"given":"Emre","family":"Belli","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Diseases, Reference Center for Complex Congenital Cardiac Disease M3C, Marie Lannelongue Hospital , 133 Avenue de la R\u00e9sistance, Plessis-Robinson 92350 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"2025072802064593100_ytaf325-B1","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1016\/j.athoracsur.2015.11.020","article-title":"Surgical intervention for anomalous origin of left coronary artery from the pulmonary artery in children: a long-term follow-up","volume":"101","author":"Naimo","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2025072802064593100_ytaf325-B2","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.ejcts.2009.03.014","article-title":"Anomalous origin of the left coronary artery from the pulmonary artery: late results with special attention to the mitral valve\u22c6","volume":"36","author":"Ben Ali","year":"2009","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025072802064593100_ytaf325-B3","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0022-5223(19)36481-5","article-title":"Anomalous origin of left coronary artery from pulmonary artery. Ligation versus establishment of a two coronary artery system","volume":"93","author":"Bunton","year":"1987","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025072802064593100_ytaf325-B4","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur Heart J"},{"key":"2025072802064593100_ytaf325-B5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1177\/2150135113505294","article-title":"Anomalous origin of circumflex coronary artery from right pulmonary artery associated with coarctation of the aorta: a case report of surgical treatment","volume":"5","author":"Sekelyk","year":"2014","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2025072802064593100_ytaf325-B6","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/0002-8703(92)90673-J","article-title":"Anomalous left circumflex coronary artery from the right pulmonary artery: first adult case report","volume":"123","author":"Garcia","year":"1992","journal-title":"Am Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf325\/63716178\/ytaf325.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/7\/ytaf325\/63716178\/ytaf325.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/7\/ytaf325\/63716178\/ytaf325.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T06:06:52Z","timestamp":1753682812000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf325\/8196070"}},"subtitle":[],"editor":[{"given":"Constantin","family":"K\u00fchl","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ivan","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Luis Antonio","family":"Moreno-Ruiz","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Karelas","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Abdullah","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":6,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf325","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,7,1]]},"article-number":"ytaf325"}}