Individualized surgical treatment strategy for children with anomalous aortic origin of coronary artery
- VernacularTitle:儿童期冠状动脉异常起源于主动脉个体化外科治疗策略
- Author:
Kai LUO
1
;
Jinghao ZHENG
1
;
Wei ZHANG
1
;
Zhongqun ZHU
1
;
Yanjun PAN
1
;
Xiaomin HE
1
;
Qi SUN
1
Author Information
1. Heart Center, Shanghai Children s Medical Center Affiliated to the Medical School of Shanghai Jiao Tong University, Shanghai, 200127, P. R. China
- Publication Type:Journal Article
- Keywords:
Anomalous aortic origin of coronary artery;
myocardial ischemia;
individualized surgical treatment strategy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(02):263-268
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize and explore the individualized surgical treatment strategy and prognosis of anomalous aortic origin of coronary artery (AAOCA). Methods The clinical data of children with AAOCA admitted to Shanghai Children's Medical Center from March 2018 to August 2021 were retrospectively analyzed. Results A total of 17 children were enrolled, including 13 males and 4 females, with a median age of 88 (44, 138) months and a median weight of 25 (18, 29) kg. All patients received operations. The methods of coronary artery management included coronary artery decapitation in 9 patients, coronary artery transplantation in 5 patients and coronary artery perforation in 3 patients. One patient with severe cardiac insufficiency (left ventricular ejection fraction 15%) received mechanical circulatory assistance after the operation for 12 days. No death occurred in the early postoperative period, the average ICU stay time was 4.3±3.0 d, and the total hospital stay was 14.4±6.1 d. All the children received regular anticoagulation therapy for 3 months after discharge. The median follow-up time was 15 (13, 24) months. All patients received regular anticoagulation therapy for 3 months after discharge. No clinical symptoms such as chest pain and syncope occurred again. The cardiac function grade was significantly improved compared with that before operation. Imaging examination showed that the coronary artery blood flow on the operation side was unobstructed, and no restenosis occurred. Conclusion AAOCA is easy to induce myocardial ischemia and even sudden cardiac death. Once diagnosed, operation should be carried out as soon as possible. According to the anatomic characteristics of coronary artery, the early effect of individualized surgery is satisfactory, and the symptoms of the children are significantly improved and the cardiac function recovers well in the mid-term follow-up.
