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2018 | 18 | 72 | 71–76
Article title

Anomalous origin of the right coronary artery from the main pulmonary artery treated surgically in a 6-week-old infant. A case report and review of the literature

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PL
Nieprawidłowe ujście prawej tętnicy wieńcowej od pnia tętnicy płucnej leczone chirurgicznie u 6-tygodniowego niemowlęcia. Opis przypadku i przegląd piśmiennictwa
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EN
Abstracts
EN
Background: In the present paper, the authors describe a case of a rare congenital defect – anomalous origin of the right coronary artery from the main pulmonary artery diagnosed in a 5-week-old infant who was deemed eligible for surgical treatment based solely on echocardiography. Such anatomical abnormalities of the coronary arteries are subtle and thus extremely difficult to visualize, especially in patients in whom permanent extensive damage of the cardiac muscle has not yet occurred. For this reason, the diagnosis is usually established when the disease is highly advanced, oftentimes only postmortem. In this paper, the authors present early echocardiographic evaluation, successful surgical treatment and post-operative echocardiographic examination. Case presentation: Fetal echocardiographic examinations demonstrated single vascular anomalies. The suspicion was verified after birth. Other congenital defects, including genetic defects, were also investigated. In the 5th week of life, cardiac ECHO showed abnormal origin of the right coronary artery from the trunk of the pulmonary artery. The child was deemed eligible for surgical treatment of the defect. The surgical translocation of the ostium of the right coronary artery to the aorta was done with success, and the child was discharged on the 14th day of hospitalization. Conclusion: The present case report demonstrates that careful examination of the child with precise echocardiographic examination makes it possible to establish an early diagnosis of this rare defect. This discrete defect can be treated early, before the symptoms, often connected with irreversible changes in the myocardium, appear.
PL
W prezentowanej pracy autorzy opisują przypadek rzadkiej wady wrodzonej – nieprawidłowego ujścia prawej tętnicy wieńcowej od pnia tętnicy płucnej, rozpoznanego u 5-tygodniowego niemowlęcia, które zostało zakwalifikowane do leczenia kardiochirurgicznego wyłącznie na podstawie badania echokardiograficznego. Takie anatomiczne nieprawidłowości tętnic wieńcowych są subtelne, a przez to niezwykle trudne do wizualizacji, szczególnie u pacjentów, u których nie doszło jeszcze do trwałego, rozległego uszkodzenia mięśnia serca. Z tego względu diagnozę zazwyczaj stawia się, gdy choroba jest znacznie zaawansowana, nierzadko dopiero po śmierci. W niniejszej pracy autorzy opisują wczesne rozpoznanie na podstawie diagnostyki echokardiograficzej, skuteczne chirurgiczne leczenie i pooperacyjne badanie echokardiograficzne. Opis przypadku: Na podstawie badań echokardiograficznych u ciężarnej wysunięto podejrzenie nieprawidłowości układu naczyniowego u płodu. Po urodzeniu podejrzenie zostało potwierdzone. U noworodka rozpoznano również inne wrodzone wady i poszukiwano cech zespołu genetycznego. W 5. tygodniu życia badanie echokardiograficzne wykazało nieprawidłowe ujście prawej tętnicy wieńcowej od pnia tętnicy płucnej. Dziecko zakwalifikowano do leczenia chirurgicznego wady. Chirurgiczne przemieszczenie ujścia prawej tętnicy wieńcowej do aorty zostało wykonane z powodzeniem i dziecko wypisano w 14. dniu hospitalizacji. Wnioski: Opisany przypadek pokazuje, że dokładne badanie dziecka wraz z precyzyjnym badaniem echokardiograficznym pozwala ustalić wczesne rozpoznanie w rzadkich chorobach. Dyskretnie objawiająca się wada może być leczona wcześnie, zanim ujawnią się objawy, zazwyczaj związane z nieodwracalnymi zmianami w myocardium. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/issues/volume-18-no-72
Discipline
Publisher

Year
Volume
18
Issue
72
Pages
71–76
Physical description
Contributors
  • Pediatric Heart Surgery and General Pediatric Surgery Department, Medical University of Warsaw, Poland, jacekpajak@poczta.onet.pl
  • Pediatric Heart Surgery and General Pediatric Surgery Department, Medical University of Warsaw, Poland
  • Cardiology Department, The Institute of Mother and Child, Warsaw, Poland
  • Pediatric Heart Surgery and General Pediatric Surgery Department, Medical University of Warsaw, Poland
author
  • Pediatric Heart Surgery and General Pediatric Surgery Department, Medical University of Warsaw, Poland
References
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Document Type
article
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bwmeta1.element.psjd-2c0de5eb-1ad2-44d7-9903-4459d701c94b
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