Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction.

Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction. Research Abstract Details 

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Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction. Abstract Text:

Wlodzimierz Kuroczynski,Christoph Kampmann,Nalan Kayhan,Markus Heinemann,Diethard Pruefer,Christian-Friedrich Vahl,

OBJECTIVES: Children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) are at risk for myocardial infarction and death. This retrospective study shows the mid-term follow-up after the use of aortic implantation and alternative methods to achieve coronary transfer. METHODS: Since 1990 seven consecutive children underwent primary repair of ALCAPA. Age at operation ranged from 2 to 71 months (median 11 months). Operative techniques included ligation (n = 1), intrapulmonary tunnel (n = 1), and aortic implantation (n = 5). One patient with severe mitral valve incompetence underwent additional mitral valve replacement. A 4-month-old patient was successfully treated after the operation with a left heart assist device. RESULTS: One death in the series occurred at 2 weeks after intrapulmonary tunneling. The mid-term results were evaluated in the six survivors with a follow-up mean of 98 months (ranged 58-168). In all surviving patients with two-vessel coronary blood supply, left ventricular end-diastolic volume and left ventricular ejection fraction returned to near normal values 2-12 months postoperatively. The mitral valve incompetence decreased in all patients with a native mitral valve. One patient with coronary ligation showed severe mitral valve regurgitation and received additional mitral valve replacement concomitantly. Six years after primary valve replacement of a 21 mm SJM (Saint Jude Medical) a change of the mechanical valve to a 27 mm valve was necessary because of development of severe stenosis due to growth. CONCLUSIONS: It is always preferable to establish an antegrade flow of oxygenated blood through the coronary arteries and to create a two-coronary artery system. Mitral valve annuloplasty or replacement may be necessary for patients with severe mitral valve incompetence.

Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction. Publishing Authors By Initials

W Kuroczynski,C Kampmann,N Kayhan,M Heinemann,D Pruefer,CF Vahl,

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Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Clinical research in cardiology : official journal

VOLUME: 97

Page Numbers: 266-71

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ISSN: 1861-0684

DAY: 22

MONTH: 02

YEAR: 2008

Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction. Information

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LANGUAGE: eng

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Country: Germany

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MEDLINETA: Clin Res Cardiol

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