A Case of Surgical Treatment of Anomalous Origin of the Single Coronary Artery from the Pulmonary Artery

Mika Noda; Hajime Sakurai; Toshimichi Nonaka; Takahisa Sakurai; Motoshi Kosakai; Yu Murakami; Mayumi Kamada; Takuya Nakayama

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A Case of Surgical Treatment of Anomalous Origin of the Single Coronary Artery from the Pulmonary Artery

VernacularTitle:単一冠動脈肺動脈起始症の1手術治験例
Author: Mika NODA ¹ ; Hajime SAKURAI ² ; Toshimichi NONAKA ² ; Takahisa SAKURAI ² ; Motoshi KOSAKAI ² ; Yu MURAKAMI ² ; Mayumi KAMADA ² ; Takuya NAKAYAMA ¹
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1. Department of Cardiovascular Surgery, Nagoya-Kyoritsu Hospital
2. Department of Cardiovascular Surgery, Chukyo Children Heart Center, Japan Community Healthcare Organization Chukyo Hospital
Keywords: congenital anomalies of the coronary artery; anomalous origin of the single coronary artery from the pulmonary artery (ASCAPA); Takeuchi procedure
From:Japanese Journal of Cardiovascular Surgery 2021;50(1):19-22
CountryJapan
Language:Japanese
Abstract: A 2-month-old male infant was transferred to our hospital for suspected cardiomyopathy because he had livedo reticularis and peripheral coldness. An electrocardiogram showed ischemic change and an echocardiogram showed a dilated, poorly functioning left ventricle. Therefore, we performed urgent cardiac catheterization. The coronary artery was not visualized by aortography, but the single coronary artery arising from the pulmonary artery was depicted by pulmonary angiography. Therefore, we performed emergent surgery. The whole coronary arteries traveled directly inferiorly from the left side of the pulmonary trunk. A patent ductus arteriosus (PDA) was closed at the operation. We established cardiopulmonary bypass using two arterial cannulae through both ascending aortas and pulmonary trunk to maintain coronary blood flow. Direct implantation is difficult because the coronary ostium is far from the ascending aorta. Therefore, we chose to perform the Takeuchi procedure using an intrapulmonary artery tunnel. The patient's postoperative course was good, and he was discharged on postoperative day 22. A case of an anomalous origin of a single coronary artery from the pulmonary artery without any other heart disease is extremely rare. Management of cardiopulmonary bypass and myocardial protection in this abnormality is discussed.