tailieunhanh - báo cáo khoa học: "Anomalous origin of the left coronary artery from the pulmonary artery associated with an accessory atrioventricular pathway and managed successfully with surgical and interventional electrophysiological treatment: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Anomalous origin of the left coronary artery from the pulmonary artery associated with an accessory atrioventricular pathway and managed successfully with surgical and interventional electrophysiological treatment: a case report | Tsoutsinos et al. Journal of Medical Case Reports 2011 5 384 http content 5 1 384 WV journalof medical l rCASE REPORTS CASE REPORT Open Access Anomalous origin of the left coronary artery from the pulmonary artery associated with an accessory atrioventricular pathway and managed successfully with surgical and interventional electrophysiological treatment a case report Alexandros Tsoutsinos1 Fotios Mitropoulos2 Christina Trapali3 and John Papagiannis4 Abstract Introduction The combination of anomalous left coronary artery origin from the pulmonary artery and an accessory pathway has not been reported previously in the medical literature. In medicine the coexistence of two clinical causes can lead to the same clinical findings and this can make the researcher s attempt to distinguish between the two of them and hence the correct diagnosis and treatment difficult. Case presentation A six-month-old boy from Pakistan was brought to our hospital with tachypnea and supraventricular tachycardia and on the basis of echocardiography and multi-slice computed tomography was diagnosed with an anomalous left coronary artery origin from the pulmonary artery. The presence of an anomalous left coronary artery origin from the pulmonary artery was not initially recognized and left ventricular dysfunction was considered as a result of supraventricular tachycardia. He underwent direct re-implantation of the left coronary artery to the aorta using the trapdoor flap technique. Recurrent episodes of supraventricular tachycardia resistant to maximal pharmacological treatment occurred post-operatively. A left posterolateral accessory pathway was successfully ablated by using a trans-septal approach. Conclusions It should not be forgotten by anyone that many times in medicine what seems obvious is not correct. It can be difficult to distinguish two clinical entities and frequently one is considered a result of the other. This is the first report of the coexistence