Anomalous origin of the left coronary artery from the pulmonary artery: repair by aortic reimplantation
- 1 January 1991
- journal article
- Published by Oxford University Press (OUP) in European Journal of Cardio-Thoracic Surgery
- Vol. 5 (7) , 368-372
- https://doi.org/10.1016/1010-7940(91)90054-n
Abstract
From 1980 to 1990, 12 patients (mean age 2.5 years, range 5 months to 9years) with anomalous origin of the left coronary artery from the pulmonaryartery were treated surgically. Five infants were operated upon in thefirst year of life because of persistent symptoms of congestive heartfailure. In all cases, a two-coronary system was constructed by directaortic reimplantation of the anomalous vessel with no deaths early or lateover a follow-up period of up to 10 years. The technique of reimplantationwas facilitated by transection of the main pulmonary artery. One patientwith severe mitral regurgitation underwent, in addition, a mitralannuloplasty. A pulmonary valvotomy was performed in another patient withassociated pulmonary stenosis. Three patients are receiving medication. Thereimplanted anomalous left coronary artery was patent in each reevaluatedpatient (10/12). Left ventricular function improved considerably in allcases. Patients with symptoms should undergo repair soon after diagnosis.Direct aortic reimplantation should be technically feasible in even thesmallest infant. Operative mortality is related to preoperative conditionsand severity of ischemic damage of the myocardium.Keywords
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