scholarly journals Longterm outcome after surgical repair of anomalous origin of the left coronary artery from the pulmonary artery -24 years of experience

2019 ◽  
Author(s):  
Joanna Kwiatkowska ◽  
Agnieszka Herrador Rey ◽  
Jarosław Meyer-Szary ◽  
Karolina Dorniak ◽  
Katarzyna Ostrowska ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Anomalous Origin ◽  
Years Of Experience ◽  
Longterm Outcome

Outcomes of surgical repair of anomalous origin of the left coronary artery from the pulmonary artery in infants and children

2021 ◽  
pp. 1-6
Author(s):  
Tong Feng ◽  
Guo Zhangke ◽  
Bai Song ◽  
Fan Fan ◽  
Zhen Jia ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Anomalous Origin ◽  
Dimension Index

Abstract Objectives: Anomalous origin of the left coronary artery from the pulmonary artery is associated with high mortality if not timely surgery. We reviewed our experience with anomalous origin of the left coronary artery from the pulmonary artery to assess the preoperative variables predictive of outcome and post-operative recovery of left ventricular function. Methods: A retrospective review was conducted and collected data from patients who underwent anomalous origin of the left coronary artery from the pulmonary artery repair at our institute from April 2005 to December 2019. Left ventricular function was assessed by ejection fraction and the left ventricular end-diastolic dimension index. The outcomes of reimplantation repair were analysed. Results: A total of 30 consecutive patients underwent anomalous origin of the left coronary artery from the pulmonary artery repair, with a median age of 14.7 months (range, 1.5–59.6 months), including 14 females (46.67%). Surgery was performed with direct coronary reimplantation in 12 patients (40%) and the coronary lengthening technique in 18 (60%). Twelve patients had concomitant mitral annuloplasty. There were two in-hospital deaths (6.67%), no patients required mechanical support, and no late deaths occurred. Follow-up echocardiograms demonstrated significant improvement between the post-operative time point and the last follow-up in ejection fraction (49.43%±19.92% vs 60.21%±8.27%, p < 0.01) and in moderate or more severe mitral regurgitation (19/30 vs 5/28, p < 0.01). The left ventricular end-diastolic dimension index decreased from 101.91 ± 23.07 to 65.06 ± 12.82 (p < 0.01). Conclusions: Surgical repair of anomalous origin of the left coronary artery from the pulmonary artery has good mid-term results with low mortality and reintervention rates. The coronary lengthening technique has good operability and leads to excellent cardiac recovery. The decision to concomitantly correct mitral regurgitation should be flexible and be based on the pathological changes of the mitral valve and the degree of mitral regurgitation.

scholarly journals Mid-term outcomes of surgical repair for anomalous origin of the left coronary artery from the pulmonary artery: In infants, children and adults

2017 ◽  
Vol 10 (2) ◽  
pp. 137 ◽  
Author(s):  
Alwaleed Al-Dairy ◽  
MaziarGholampour Dehaki ◽  
Yousef Rezaei ◽  
AlirezaAlizadeh Ghavidel ◽  
Gholamreza Omrani ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Anomalous Origin

scholarly journals Early and midterm results after surgical repair of anomalous origin of the left coronary artery from the pulmonary artery

2019 ◽  
Vol 147 (9-10) ◽  
pp. 567-570
Author(s):  
Sergej Prijic ◽  
Stasa Krasic ◽  
Jovan Kosutic ◽  
Mila Stajevic ◽  
Sanja Ninic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Operative Treatment ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Heart Function ◽  
Left Ventricular ◽  
Anomalous Origin ◽  
Z Score ◽  
Echocardiographic Parameters

Introduction/Objective. The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is rare congenital disease, which causes myocardial ischemia and subsequent heart failure in infants. The aim is early and mid-term follow up evaluation of the heart function after surgical repair of ALCAPA. Methods. Investigation was retrospective and included medical records of the ALCAPA patients treated surgically, between 2009 and 2017, at the tertiary referent heart center. Results. Five patients (four girls) with coronary anomaly were included in the study. All patients had significantly increased left ventricular end diastolic diameter (z-score 6.6 ? 2.43) and left atria size (z-score 3.09 ? 0.37), along with decreased systolic function (ejection fraction 34.8 ? 7.4% and fractional shortening 15.5 ? 3.4%). The surgery was performed on average at the age of 8.2 ? 7.8 months. Operative treatment was associated with early improvement in echocardiographic parameters (except the size of the left atria). Patients were followed for 4.5 ? 2.6 years. Improvement in echocardiographic parameters was age-related. Patients under four months had recovery early after surgery, those treated at 5.5?6 months of age had normalization after 12 months, and patient who was recognized in the second year of life had late recovery (after ? 24 months). Conclusion. Operative treatment in the first 3?4 months of life is related with the most favorable prognosis and rapid normalization of the echocardiographic parameters.

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