Aortic implantation is possible in all cases of anomalous origin of the left coronary artery from the pulmonary artery

Turley, Kevin; Szarnicki, Robert J.; Flachsbart, Keith; Richter, R; Popper, Robert W.; Tarnoff, Harold

doi:10.1016/s0003-4975(95)00355-x

Cited by 118 publications

(27 citation statements)

References 16 publications

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“…On the other hand, satisfactory outcomes of the translocation procedure have already been described in several reports, and translocation was reported to be possible wherever the LCA origin is located, if extension with various materials was concomitantly performed. 15 However, if the focus is on cases of a remotely located LCA orifice only, then few reports exist 2,4,7,13,16-18 and our results would be valid. Table 3 shows the various surgical methods and outcomes in patients with ALCAPA and a remotely located LCA orifice.…”

Section: Discussionmentioning

confidence: 51%

Indication of Takeuchi Technique for Patients With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Hoashi

Kagisaki

Okuda

et al. 2013

Circ J

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Background: Intrapulmonary tunnel repair, called the Takeuchi technique, is a unique procedure for repairing anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Since 1986, we have clearly defined the indication for the Takeuchi technique based on the location of the left coronary artery (LCA) orifice. Methods and Results:From 1986 to 2011, 19 consecutive patients with ALCAPA underwent surgical repair; the dual-coronary system was reconstructed in 16 of these patients with either Takeuchi (n=9: 1 male; median age 14.7 years; median weight 42.7 kg) or a translocation procedure (n=7, 3 males; 0.4 years old, 5.6 kg). Takeuchi was performed in patients whose LCA arose far from the aorta (middle of posterior facing sinus in 3 patients, left side of posterior facing sinus in 2, non-facing sinus in 4). The mean postoperative follow-up period was 7.4±6.1 years in the Takeuchi group and 9.3±8.5 years in the Translocation group. Actuarial survival rate at 10 years was 87.5% and 71.4%, respectively, and the freedom from either reoperation or re-intervention rate at 10 years was 67.7% and 85.7%, respectively. All the patients who died had a preoperative left ventricular ejection fraction ≤30%. Conclusions:The long-term outcome of the Takeuchi technique was acceptable. Although late reoperation and/or re-intervention cannot be disregarded, Takeuchi can be recommended when the LCA arises far from the aorta. (Circ J 2013; 77: 1202 -1207

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Section: Discussionmentioning

confidence: 51%

Indication of Takeuchi Technique for Patients With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Hoashi

Kagisaki

Okuda

et al. 2013

Circ J

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“…These symptoms, in association with cardiomegaly, should prompt the clinician to look for Q waves in leads AVL and V4-V6 [11]. It is imperative that children with suspected ALCAPA be referred to a tertiary paediatric cardiac centre as soon as possible as the only way to reverse the coronary ischaemia is by surgical correction [12][13][14]. Coronary ischaemia is often so profound that irreversible myocardial damage may have already occurred.…”

Section: Discussionmentioning

confidence: 99%

A review of 15-year experience with anomalous origin of the left coronary artery

et al. 2008

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“…10) In this technique, in order to bridge the gap between the anomalous coronary artery and the aorta, a noncircumferential segment of the pulmonary artery is used to provide a tunnel. As viable native tissues are used during this procedure, this technique also provides the future growth of the implanted artery.…”

Section: Discussionmentioning

confidence: 99%

Intermediate-term Results after Surgery for Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

Kırbaş

Gürer

Bilal

2012

ATCS

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Purpose: Anomalous origin of the left coronary artery from the pulmonary artery is optimally treated by creating a dual coronary system. Our aim was to review the results of operations performed in these patients and determine the intermediate-term outcomes for left ventricular function and mitral regurgitation. Methods: Between July 2004 and January 2009 seven patients (5 boys, 2 girls) aged between 4 months and 12 years (median, 4.5 years) were operated for anomalous origin of the left coronary artery from the pulmonary artery. The surgical correction was either performed by direct implantation (58%) or restoration of a composite tunnel (42%). Simultaneous mitral annuloplasty was performed in one patient with severe mitral regurgitation and simultaneous total correction of tetralogy of Fallot was performed in another. Results: There was no hospital or late deaths. Postoperative echocardiograms demonstrated a significant improvement in the left ventricular ejection fraction (52% ± 6% versus 39% ± 8%, P = 0.02) and mitral regurgitation (11% mild versus 48% moderate, P = 0.02) compared to those obtained preoperatively. Conclusion: Direct re implantation of the left coronary artery to the aorta and restoration of a composite tunnel from aortic and pulmonary artery walls are equally effective techniques with an acceptable operative mortality, excellent cardiac recovery, and intermediate survival.Keywords: congenital cardiac disease, echocardiography, mitral valve, mitral regurgitation, left ventricular function, pulmonary artery, left coronary artery Ann Thorac Cardiovasc Surg 2012; 18: 12-17 doi: 10.5761/atcs.oa.11.01696 genital heart disease.3) It is one of the most common causes of myocardial ischemia and infarction in children, and if not treated, results in mortality rate of up to 90% within the first year of life. 4) During the neonatal period, increased pulmonary artery pressures, resulting from the high pulmonary vascular resistance, lead to an antegrade flow from the pulmonary artery into the anomalous left coronary artery. However, as the pulmonary vascular resistance gradually decreases, left-to-right shunting increases. Consequently, left ventricular perfusion becomes dependent on intracoronary collateral circulation from an enlarged right coronary artery. Coronary steal results in ischemia, and subsequent infarction of left ventricular myocardium and anterolateral papillary muscle ischemia leads to mitral regurgitation. The current standard management in patients with anomalous origin of the left

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Aortic implantation is possible in all cases of anomalous origin of the left coronary artery from the pulmonary artery

Cited by 118 publications

References 16 publications

Indication of Takeuchi Technique for Patients With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Indication of Takeuchi Technique for Patients With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

A review of 15-year experience with anomalous origin of the left coronary artery

Intermediate-term Results after Surgery for Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

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