Anomalous origin of the left coronary artery from the pulmonary artery: collective review of surgical therapy

Dodge‐Khatami, Ali; Mavroudis, Constantine; Backer, Carl L.

doi:10.1016/s0003-4975(02)03633-0

Cited by 323 publications

(333 citation statements)

References 65 publications

Supporting

Mentioning

297

Contrasting

Unclassified

Order By: Relevance

“…In patients under warfarin therapy, it is possible to perform procedure by switching to low molecular weight heparin when necessary. In larger mediastinal defects including heart with bypassed grafts, controlled application of lower pressure (75-100 mmHg) as well as prevention of the risk of right ventricle rupture via use of barrier isolating polyvinyl alcohol from sterile gas seems possible (2)(3)(4)(5).…”

Section: İstenmeyen Bir Komplikasyonun Başarılı Tedavisi; Vac Terapimentioning

confidence: 99%

“…Although establishing dual coronary circulation in childhood is a common practice, treatment of this anomaly in adult patients is controversial. Among various treatment options, establishing dual coronary circulation seems to provide better survival and significant recovery in ventricular functions (1,3,4). We performed combined simple closure and coronary artery bypass procedure to establish dual coronary circulation.…”

mentioning

confidence: 99%

“…About 10% of ALCAPA patients can survive to adulthood by welldeveloped intercoronary and extra coronary systemic collaterals (mainly from the bronchial arteries) (2,4). Excessive collateral flow is a challenge during administration and maintenance of cardioplegia and coronary anastomoses in these patients (3)(4)(5).…”

mentioning

confidence: 99%

“…Excessive collateral flow is a challenge during administration and maintenance of cardioplegia and coronary anastomoses in these patients (3)(4)(5). In order to facilitate anastomoses, several techniques have been suggested such as gentle compression of atrioventricular groove (3) but to our knowledge, this is the first report suggesting use of an intracoronary shunt during such an on-pump procedure.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Intracoronary shunt use in an adult patient with Bland-White-Garland syndrome

Özkaynak¹,

Yildirim²,

Orman³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Bland-White-Garland sendromlu yetişkin hastada intrakoroner şant kullanımıThe anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA or Bland-White-Garland syndrome) is a rare congenital heart defect with an incidence of 1 in 300.000 live births (1). Although it is the most common congenital coronary artery anomaly comprising 0.24%-0.46% of all congenital cardiac anomalies, only 10% of patients survive to adulthood (1, 2).A 44 -year old man was referred to our clinic because of chest pain on exertion. Left main coronary artery (LMCA) could not be visualized during conventional coronary angiography. Computed tomography angiography revealed abnormal origin of the left coronary artery from the pulmonary artery (PA) and muscular bridging of the left anterior descending (LAD) coronary artery (Fig. 1). During the operation, aortic arterial and bicaval venous cannulation, intermittent antegrade and retrograde blood cardioplegia were used. Right coronary artery was aneurysmatic due to collateral flow ( Fig. 2A, B). Through the pulmonary arteriotomy, LMCA orifice was seen to be originating from the left posterior sinus of PA and it was closed primarily by Teflon pledgeted 4/0 polypropylene sutures. Excessive systemic collateral flow was impeding exposure despite a properly placed aortic cross-clamp and a fully arrested and vented heart. Intracoronary shunts (ClearView ® Medtronic Inc. Minneapolis, MN, USA) were used to divert flow away from the site of anastomosis. Left internal mammary artery and a saphenous vein graft were anastomosed to LAD and circumflex artery respectively. The patient was discharged on the sixth postoperative day after an uneventful recovery. He is well and free of ischemic symptoms in his second year following the operation.In untreated adult ALCAPA patients, sudden death secondary to myocardial ischemia and cardiomyopathy is seen with an incidence of 80-90% at a mean age of 35 years (1, 2). Although establishing dual coronary circulation in childhood is a common practice, treatment of this anomaly in adult patients is controversial. Among various treatment options, establishing dual coronary circulation seems to provide better survival and significant recovery in ventricular functions (1, 3, 4). We performed combined simple closure and coronary artery bypass procedure to establish dual coronary circulation.About 10% of ALCAPA patients can survive to adulthood by welldeveloped intercoronary and extra coronary systemic collaterals (mainly from the bronchial arteries) (2, 4). Excessive collateral flow is a challenge during administration and maintenance of cardioplegia and coronary anastomoses in these patients (3)(4)(5). In order to facilitate anastomoses, several techniques have been suggested such as gentle compression of atrioventricular groove (3) but to our knowledge, this is the first report suggesting use of an intracoronary shunt during such an on-pump procedure. Contrary to the common knowledge that intracoronary shunts are used in off-pump surgery, we used them in ...

show abstract

Section: İstenmeyen Bir Komplikasyonun Başarılı Tedavisi; Vac Terapimentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Intracoronary shunt use in an adult patient with Bland-White-Garland syndrome

Özkaynak¹,

Yildirim²,

Orman³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…18 Prevalence of ARCAPA or anomalous right coronary artery arising from the pulmonary artery is estimated to be one in 50,000 of the general population. 19 Because symptoms in ARCAPA are less pronounced as compared with ALCAPA and can even remain unnoticed, prevalence figures are not very robust and are based on a limited number of case reports.…”

Section: A B Cmentioning

confidence: 99%

Coronary artery anomalies detected by MSCT-coronary angiography in the adult

Kate¹,

Weustink²,

Feyter³

2008

NHJL

View full text Add to dashboard Cite

Background. Before coronary evaluation by modern imaging techniques was feasible, premorbid diagnoses of coronary artery anomalies (CAAs) were usually made fortuitously by invasive coronary angiography (ICA). However, this technique is limited by its invasive and projectional nature. Coronary magnetic resonance angiography (CMRA) and multi-slice computed tomography (MSCT) broadened clinical information by enabling visualisation of the coronary arteries in their anatomical environment. Methods. This case series visualises and reviews anomalous coronary artery from the opposite sinus (ACAOS) and coronary artery fistulae. All CAAs were detected by means of 64-slice dual source computed tomography after 1000 cardiac scans at the Erasmus MC, Rotterdam, the Netherlands. Results. Eight ACAOS cases, one anomalous left coronary artery from the pulmonary artery (ALCAPA) and one congenital aneurysm of an aortic sinus were found. Seven out of ten detected CAAs were considered malignant whereas three CAAs of the ACAOS type (retroaortic path) were considered benign. Significant coronary artery disease was found in three out of eight ACAOS cases. In one of the ACAOS cases complete evaluation of the anomalous coronary artery was limited by motion artifacts. All five cases of right ACAOS were referred for MSCT because the right coronary artery could not be located by invasive angiography. Keywords: coronary anomalies, anomalous coronary artery from the opposite sinus, coronary artery fistulae, computed tomography, invasive coronary angiography Conclusion. All CAAs

show abstract

References

2003

The Natural and Modifed History of Congenital Heart Disease

View full text Add to dashboard Cite

Anomalous origin of the left coronary artery from the pulmonary artery: collective review of surgical therapy

Cited by 323 publications

References 65 publications

Intracoronary shunt use in an adult patient with Bland-White-Garland syndrome

Intracoronary shunt use in an adult patient with Bland-White-Garland syndrome

Coronary artery anomalies detected by MSCT-coronary angiography in the adult

References

Contact Info

Product

Resources

About