Open AccessNoonan syndrome associated with anomalous left coronary artery from the pulmonary artery in a patient with the rare RAF1 mutation: A case report and review of literature
Author(s) -
Richard U. Garcia,
Raya Safa,
Chelsea Evans,
Dominic Alessio,
Ralph E. Delius,
Bahig M. Shehata
Publication year - 2019
Publication title -
annals of pediatric cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.292
H-Index - 19
eISSN - 0974-2069
pISSN - 0974-5149
DOI - 10.4103/apc.apc_144_18
Subject(s) - medicine , cardiology , extracorporeal membrane oxygenation , pulmonary artery , left coronary artery , noonan syndrome , artery , heart failure , endocardial fibroelastosis , right pulmonary artery , mitral valve replacement , cardiomyopathy , mitral valve
We present the case of a 7-week-old male infant diagnosed with anomalous left coronary artery from the pulmonary artery (ALCAPA) who underwent repair by left coronary artery reimplantation, followed by an eventful postoperative period including need for venous arterial extracorporeal membrane oxygenation and mitral valve replacement due to mitral calcification and severe insufficiency. He also required heart transplant due to severe rapidly progressive biventricular hypertrophy. The pathology examination of the explanted heart showed massive cardiomegaly. Subsequently, the infant's cardiomyopathy panel was positive for RAF1 mutation, consistent with diagnosis of a rare form of Noonan syndrome. To our knowledge, this autosomal dominant condition in association with ALCAPA has not been previously reported in the literature.