An Alternative Surgical Technique for Repair of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery.
- Author:
Young Su KIM
1
;
Mina LEE
;
Yang Hyun CHO
;
Ji Hyuk YANG
;
Tae Gook JUN
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. tg.jun@samsung.com
- Publication Type:Original Article
- Keywords:
Coronary vessel anomalies;
Bland white Garland syndrome;
Replantation;
Congenital heart disease
- MeSH:
Aorta;
Bland White Garland Syndrome;
Cerebral Hemorrhage;
Coronary Vessel Anomalies;
Coronary Vessels*;
Diaphragm;
Echocardiography;
Follow-Up Studies;
Heart Defects, Congenital;
Humans;
Mortality;
Paralysis;
Pulmonary Artery*;
Replantation;
Ventricular Function
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2014;47(3):220-224
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: For the surgical management of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), there have been various techniques that reduce the tension and kinking of the coronary artery during reimplantation to the aorta. The aim of this study is to describe the results of our modified technique of coronary reimplantation for the treatment of ALCAPA. METHODS: Between October 2003 and February 2011, seven patients underwent coronary reimplantation with the modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta). The median follow-up duration was 52 months (range, 4 to 72 months). Clinical outcomes and serial echocardiographic data were reviewed. RESULTS: There was no mortality. One patient had a small amount of cerebral hemorrhage postoperatively and improved without any sequelae. Another patient had left diaphragm palsy and underwent diaphragm plication. Follow-up echocardiogram showed that all patients had normal ventricular function without chamber enlargement. CONCLUSION: Our modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta) demonstrated successful clinical outcomes. We conclude that this surgical technique can be a potential alternative for the treatment of ALCAPA.
