Surgery for anomalous aortic origin of the coronary artery arising from the inappropriate sinus in children
10.3760/cma.j.cn112434-20200316-00132
- VernacularTitle:儿童冠状动脉异常起源于异位窦的外科治疗
- Author:
Dong WANG
1
;
Yongtao WU
;
Pei CHENG
;
Xiangming FAN
;
Junwu SU
Author Information
1. 首都医科大学附属北京安贞医院 北京市心肺血管病研究所小儿心脏中心 100029
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(8):454-457
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the experience of surgical treatment of anomalous aortic origin of the coronary artery arising from the inappropriate sinus(AAOCA) in children.Methods:Between April 2016 and November 2019, the clinical data of 9 patients with AAOCA in Anzhen Hospital were retrospectively analyzed, including 5 males and 4 females; aged from 5 month to 15 years old, with an average(11.7±5.1) years old. The clinical symptoms, auxiliary examination, treatment methods and prognosis of AAOCA patients were analyzed retrospectively.Results:The diagnosis of AAOCA was confirmed by echocardiography and coronary computed tomography angiography in all 9 cases. Left coronary arteries originated from the right coronary sinus in 4 cases, and right coronary arteries originated from the left coronary sinus in 5 cases. Two cases had a history of sudden cardiac death, and 1 case had a history of acute myocardial infarction; except for one asymptomatic case, other children had chest tightness, chest pain, syncope and other symptoms. Surgery was successfully completed in all children, included 7 cases of unroofing surgery, 1 case of coronary translocation and pulmonary translocation, and 1 case of inter-aortic release. There were no death in-hospital and serious complications. The postoperative follow-up period ranged from 3 months to 4 years. During the follow-up period, no patient died with normal heart function; 2 cases had nonspecific chest tightness and chest pain, and there was no evidence of myocardial ischemia.Conclusion:Younger AAOCA patients have a high rate of sudden cardiac death. Once diagnosed, early surgical treatment is needed. Coronary unroofing procedures and coronary translocation are recommended for AAOCA children with safe and reliable.
