Anomalous origin of the coronary arteries from the pulmonary artery: ALCAPA and ARCAPA

The first descriptions of anomalous coronary arteries (CA) from the pulmonary artery (PA) were performed by Krause in 1865 and by Brooks in 1885. They reported the presence of accessory arteries originating from the anterior side of the PA and joining a network of thoraco-mediastinal thoracic vessels, including CAs branches normally originating from the aorta. The first adult report of anomalous left CA (LCA) from PA (ALCAPA) came in 1908 from Maude Abbott's contribution to Osler's Modern Medicine. Thereby, she reported the case of an asymptomatic 60-year-old woman with a dilated and aneurysmal right coronary artery (RCA) giving off branches that anastomosed with venous-like vessels running in the normal territory of the LCA, but originating from the posterior sinus of the PA. Such autoptic finding became known as Bland-White-Garland syndrome in 1933, with the landmark publication of a 3-month-old infant with autopsy confirmed ALCAPA [1].