CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 8, September 2012
e10
AFRICA
described. However with a well-established collateral circulation,
these patients may sometimes present only in adulthood. When
this occurs, surgical re-implantation or bypass of the left main
coronary system is usually recommended.
flow being shunted away from the myocardium and into the
low-pressure pulmonary artery.
ALCAPA is one of the most common causes of myocardial
infarction in children, and an initial presentation with ischaemic
mitral regurgitation within the first few weeks of life is well
Fig. 3. Reformatted maximum-intensity projection image
reconstructed in an oblique plane demonstrating multiple
intercoronary collateral vessels.
Fig. 4. Reformatted maximum-intensity projection image
reconstructed in a short-axis plane demonstrating a large
septal collateral vessel. Left ventricle (LV).
Collateral
Vessels
Collateral
Vessel
PDA
LAD
LV
