Surgical Treatment in Patients With Anomalous Left Coronary Artery From Pulmonary Artery Combining Severe Left Ventricular Dysfunction
10.3969/j.issn.1000-3614.2017.09.020
- VernacularTitle:左冠状动脉起源于肺动脉合并重度左心功能不全的外科治疗
- Author:
wei Chang ZHANG
1
;
jun Shou LI
;
Hao ZHANG
;
wei Hua GAO
;
xia Fu YAN
;
ping Jin LIU
;
Xu WANG
Author Information
1. 中国医学科学院北京协和医学院国家心血管病中心阜外医院小儿外科中心
- Keywords:
Cardiovascular abnormalities;
Vascular grafting;
Vevtricular dysfunction,left
- From:
Chinese Circulation Journal
2017;32(9):917-920
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the surgical treatment result in patients with anomalous left coronary artery from pulmonary artery (ALCAPA) combining severe left ventricular dysfunction.Methods:A total of 24 ALCAPA patients combining severe left ventricular dysfunction received coronary reimplantation in our hospital from 2009-02 to 2016-04 were retrospectively studied.The patients' mean age was 7.0 (5.0,17.8)months including 13 male;mean left ventricular ejection fraction (LVEF)＜30％ and the median pre-operative LVEF was 21.0％ (17.3％,26.5％).Results:There were 2/24 (8.3％) in-hospital death,The median cardiopulmonary bypass time was 109 (95,128) min,aorta cross-clamp time 65 (48,87) min,mechanical ventilation time 94.5 (48.3,165.5) h and ICU stay time 176.5 (101.0,305.3) h;2 patients received ECMO support and weaned off successfully and 2 patients received re-intubation.In 22 survival patients,the median discharge LVEF was 26.0％ (20％,35％) which was similar to pre-operative condition,P＞0.05.The mean follow-up time was (15.3±14.9) months at the longest of 63 months,no re-admission,reoperation and death occurred.The patients had NYHA I and the last follow-up LVEF was 60％ (50％,69％) which was increased than discharge level,P＜0.05,4 patients had LVEF＜50％.Conclusion:Surgical treatment had satisfactory short-and mid-term outcomes in ALCAPA patients combining severe left ventricular dysfunction;comprehensive effort should be emphasized in surgery,anesthesia,cardiopulmonary bypass and ICU management at peri-operative period.
