Long-Term Results of Repair of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Lange, Rüdiger; Vogt, Manfred; Hörer, Jürgen; Cleuziou, Julie; Menzel, Andrea; Holper, K; Hess, John; Schreiber, Christian

doi:10.1016/j.athoracsur.2006.11.005

Cited by 179 publications

(135 citation statements)

References 31 publications

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“…In cases of AL-CAPA in young children, favourable results have been followed after re-establishment of a dual coronary system through re-implantation of the left coronary artery to the aorta or by bypass grafting and ligation of proximal ALCAPA [16]. When dual coronary system cannot be established either due to anatomical limitations or because of significant surgical co-morbidities, closure of the anomalous artery through surgical ligation or by the use of a percutaneous vascular plug may lead to clinical…”

Section: Resultsmentioning

confidence: 99%

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Dilawar¹,

Ahmad²

2012

OJPed

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Anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly. In this study, we present all the ALCAPA patients which were admitted at our institution during April 2007-December 2010. Retrospective review of these patients regarding their clinical presentation and the use of diagnostic modalities will be presented in this series. There were total of five patients, three male and 2 female, with age range of 2 -12 months. The most common symptoms at presentation were tachypnea (4/5) and poor feeding with irritability (3/5). Electrocardiogram was abnormal in 2/5 cases and chest X ray revealed cardiomegaly with pulmonary congestion in 4/5 patients. Echocardiogram showed mitral valve regurgitation in 5/5 cases (3 with moderate and 2 with mild to moderate), Left ventricular dilatation/dysfunction in 4/5 patients, echogenic left ventricular papillary muscles in 4/5 patients and prominent right coronary with strong suspecision of ALCAPA in 4/5 patients. Coronary angiography was performed in 4/5 cases to confirm the diagnosis. We conclude that by thorough clinical assessment along with ECG and CXR, the diagnosis of ALCAPA can be strongly suspected. Echocardiogram can almost always make the diagnosis of ALCAPA and coronary angiography can confirm the diagnosis in rare atypical cases.

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Section: Resultsmentioning

confidence: 99%

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Dilawar¹,

Ahmad²

2012

OJPed

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“…[22][23][24] Progress in diagnosis, surgical techniques, and postoperative care has yielded dramatic prognostic improvements in ALCAPA patients: mortality rates have declined from 90% to ≤20%. [25][26][27][28][29] We think that the best repair technique for ALCAPA is reimplantation of the LCA in the aortic root, and indeed this has produced results superior to those of other techniques. [30][31][32] Our hospital's surgeons have extensive experience with the arterial switch operation and greatly prefer the more anatomic coronary-transfer technique to the Takeuchi procedure.…”

Section: A B Cmentioning

confidence: 99%

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Rodríguez-González¹,

Tirado²,

Hosseinpour³

et al. 2015

Texas Heart Institute Journal

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“…The treatment of choice is surgical left main coronary artery reimplantation into the aorta [3]. Data regarding long-term follow-up are limited and despite apparent good left ventricle (LV) systolic function, as assessed by standard echocardiography, follow-up complications such as persistent mitral regurgitation, congestive heart failure, and coronary stenosis may necessitate reinterventions, including heart transplantation [4,5,6,7]. Advanced echocardiographic technique, such as speckle tracking echocardiography (STE), allows angle-independent assessment of cardiac mechanics and has demonstrated in several studies the ability to detect early subclinical myocardial abnormalities, even in the presence of normal LV ejection fraction (EF) [8,9].…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Mechanics in Patients with Abnormal Origin of the Left Main Coronary Artery from the Pulmonary Trunk Late after Successful Repair

Salvo

Siblini²,

Issa³

et al. 2016

Cardiology

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Objective: Our aim was to evaluate left ventricular (LV) mechanics by using speckle tracking echocardiography (STE) in asymptomatic patients with abnormal origin of the left main coronary artery from the pulmonary trunk (ALCAPA), late after successful repair, in the presence of LV ejection fraction (EF) >50%. Methods: We studied 30 ALCAPA patients (median age 4 years, range 1-25 years, NYHA class I, LVEF >50%) and 16 healthy age- and sex-matched controls (median age 5 years, range 1-25 years). All underwent standard echocardiographic evaluation and STE. Results: LV dimensions and LVEF (63.6 ± 8.2% vs. 64.1 ± 5.1%, p = 0.826) were not different between patients and controls. Diastolic parameters were significantly abnormal in our patients versus controls (E/e' average: 11.9 ± 5.8 vs. 6.6 ± 3.0, p = 0.0014). Global LV longitudinal strain was significantly lower in ALCAPA patients versus controls (-17.6 ± 3.5% vs. -23.4 ± 3.1%, p < 0.0001). LV torsion (9.1 ± 4.9° vs. 11.9 ± 3.3°, p = 0.046) was significantly impaired in ALCAPA patients. Conclusions: After successful repair in asymptomatic ALCAPA patients, despite an LVEF >50%, diastolic function, LV longitudinal deformation and LV torsion remain impaired. We suggest including a detailed study of the diastolic function and cardiac mechanics in the clinical follow-up of these patients to identify the subgroup of patients at higher risk.

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Long-Term Results of Repair of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

Cited by 179 publications

References 31 publications

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Anomalous left coronary artery from pulmonary artery: Case series and brief review

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Left Ventricular Mechanics in Patients with Abnormal Origin of the Left Main Coronary Artery from the Pulmonary Trunk Late after Successful Repair

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