{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:33:00Z","timestamp":1783636380739,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,1,24]],"date-time":"2013-01-24T00:00:00Z","timestamp":1358985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2013,8]]},"abstract":"Background<\/jats:title>Late presentation of abnormal origin of coronary artery from the pulmonary artery (ACAPA<\/jats:styled-content>) is uncommon compared with early presentation, which usually induces extended myocardial necrosis and severe heart failure. The late presentation is characterized by abundant development of intercoronary collaterals resulting in mild and rare symptoms, but nevertheless can cause sudden cardiac death. Our objective was to describe presentation, cardiovascular imaging methods for diagnosis and outcomes of patients with late presentation of ACAP<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>The study is a retrospective review of a single\u2010center database to identify all patients diagnosed with ACAPA<\/jats:styled-content> beyond the first year of life.<\/jats:p><\/jats:sec>Results<\/jats:title>From 1976 to 2011, 10 patients were identified with ACAPA<\/jats:styled-content> at the age of 1.1\u201364\u00a0years: 6 with left coronary artery from the pulmonary artery (ALCAPA<\/jats:styled-content>) and 4 with right coronary artery from the pulmonary artery (ARCAPA<\/jats:styled-content>). Echocardiography and D<\/jats:styled-content>oppler imaging evidenced: (1) direct signs: the abnormal coronary ostium arising from the pulmonary trunk with retrograde coronary artery flow and (2) indirect signs: abundant intercoronary septal collaterals with anterograde flow (ARCAPA<\/jats:styled-content>) or retrograde flow (ALCAPA<\/jats:styled-content>) and dilatation of the controlateral normally originated coronary artery. Nine patients underwent surgical implantation of the ACAPA<\/jats:styled-content> into the ascending aorta. After 7.9\u00a0years mean follow\u2010up, all were asymptomatic except one who required a second surgery.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Noninvasive cardiovascular imaging, namely transthoracic echocardiography and D<\/jats:styled-content>oppler specific parameters, can reach diagnosis of late presentation of ACAPA<\/jats:styled-content>. Direct aortic implantation is a reliable and effective to establish dual coronary artery circulation and prevent risks due to myocardial ischemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.12124","type":"journal-article","created":{"date-parts":[[2013,1,24]],"date-time":"2013-01-24T17:33:25Z","timestamp":1359048805000},"page":"829-836","source":"Crossref","is-referenced-by-count":17,"title":["Focus on Echocardiographic and D<\/scp>oppler Analysis of Coronary Artery Abnormal Origin from the Pulmonary Trunk with Mild Myocardial Dysfunction"],"prefix":"10.1111","volume":"30","author":[{"given":"Pierre\u2010Yves","family":"Courand","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease Louis Pradel Hospital Hospices civils de Lyon Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon I Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Bozio","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Louis Pradel Hospital Hospices civils de Lyon Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon I Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Ninet","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Louis Pradel Hospital Hospices civils de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Henaine","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Louis Pradel Hospital Hospices civils de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Veyrier","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Louis Pradel Hospital Hospices civils de Lyon Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon I Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bakloul","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Louis Pradel Hospital Hospices civils de Lyon Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon I Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loic","family":"Boussel","sequence":"additional","affiliation":[{"name":"Department of Hemodynamics and Radiology Louis Pradel Hospital Hospices civils de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie Di","family":"Filippo","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease Louis Pradel Hospital Hospices civils de Lyon Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon I Lyon 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