New surgical method for repair of anomalous left coronary artery from pulmonary artery

Takeuchi, Shigeyuki; Imamura, Hiroji; Katsumoto, K; Hayashi, Ikuo; Katohgi, T; Yozu, Ryohei; Ohkura, Mikihiko; Inoue, Tadashi

doi:10.1016/s0022-5223(19)38154-1

Cited by 311 publications

(134 citation statements)

References 14 publications

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“…is baffle leak and pulmonary stenosis. 9,10 Currently, the translocation procedure aims to establish the dual-coronary system and has become more popular with satisfactory outcome. In our case, surgery was highly recommended even though the patient showed no obvious myocardial ischemia at the time of admission.…”

Section: Discussionmentioning

confidence: 99%

A rare case of anomalous origin of the left anterior descending artery from the pulmonary artery

Zhang

Wang

et al. 2019

Echocardiography

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease, with an incidence of <1 in 300 000 live births. We describe a rare case of a 23‐month‐old infant admitted for cough and fever. Echocardiography showed a branch of the left coronary artery originating from the pulmonary artery. The coronary computed tomographic angiography revealed anomalous origin of the left anterior descending (LAD) artery from the pulmonary artery with the left circumflex artery and right coronary artery arising normally from the aorta. The infant successfully underwent surgical reimplantation of the LAD to the ascending aorta. Our case emphasizes that echocardiography and computed tomographic angiography are valuable imaging modalities for making an accurate diagnosis and determining the precise surgical plan.

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Section: Discussionmentioning

confidence: 99%

A rare case of anomalous origin of the left anterior descending artery from the pulmonary artery

Zhang

Wang

et al. 2019

Echocardiography

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“…25 In 1983, Moodie et al showed a patency rate of only 80% in SVGs after a mean follow up of 5.8 years. 26 The creation of an aortopulmonary window to the coronary artery when coronary anatomy repair to create a dual coronary system was not feasible was proposed by Takeuchi et al 27 This procedure is associated with high incidence of supravalvular pulmonary stenosis and obstruction of the baffle. 28 Orthotopic heart transplant is an option in selected adults where the myocardial dysfunction is not reversible despite surgical correction with the establishment of dual coronary system.…”

Section: Discussionmentioning

confidence: 99%

The Management of the Older Adult Patient with Anomalous Left Coronary Artery from the Pulmonary Artery Syndrome: A Presentation of Two Cases and Review of the Literature

et al. 2013

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ALCAPA (anomalous left coronary artery from pulmonary artery) syndrome is a rare congenital abnormality that involves an anomalous insertion of the left coronary artery into the pulmonary artery. Ninety percent of patients present in the first year of life with signs and symptoms of heart failure or sudden cardiac death secondary to chronic myocardial ischemia. There have been an increasing number of reports of ALCAPA patients surviving to adulthood. There seems, however, to be a tendency to die suddenly in the third decade of life. Adult survivors are either asymptomatic or present with mitral regurgitation, cardiomyopathy, myocardial ischemia, or malignant arrhythmias. The management of the older patient presenting with symptoms resulting from ischemia and progressive left ventricular dysfunction remains a challenge. Treatment is largely based on guidelines for adult congenital heart disease management and an extrapolation of evidence from heart failure practice. Currently, surgical reimplantation of the anomalous coronary onto the aorta is the mainstay of treatment. The management of heart failure, sudden cardiac death, and ventricular arrhythmia present problems that are not addressed by reimplantation of the anomalous vessel alone. In this report, we present two cases with different modes of presentation and discuss treatment options.

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“…In adults diagnosed with ALCAPA, several surgical treatment options have been proposed. [5][6][7] In this case, ligation of the anomalous artery at its origin combined with CABG was selected to reinstall a two-coronary system. Identification and location of the anomalous origin of the LCA from the PA remains challenging for many surgeons because the origin of the ALCA is not the same in all patients and the extensive, tortuous, dilated collateral coronary circulation around the right ventricular outflow tract and PA region can make identifying the orifice of LCA from the PA difficult.…”

Section: Discussionmentioning

confidence: 99%

Successful Intraoperative Identification of an Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Using Real Time Three-Dimensional Transesophageal Echocardiography

et al. 2011

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Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare congenital defect that presents only infrequently in adults. An adult diagnosed with ALCAPA, heart failure, and mitral regurgitation underwent surgical ligation of the anomalous origin of the LCA from the pulmonary artery (PA) and coronary artery bypass grafting (CABG). The anomalous origin in the PA and proximal segment of the left anterior descending artery (LAD) was successfully delineated via real time, three-dimensional transesophageal echocardiography during surgery. This modality allows for fast assessment and novel views of complex cardiac abnormalities and can aid in perioperative monitoring.

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New surgical method for repair of anomalous left coronary artery from pulmonary artery

Cited by 311 publications

References 14 publications

A rare case of anomalous origin of the left anterior descending artery from the pulmonary artery

A rare case of anomalous origin of the left anterior descending artery from the pulmonary artery

The Management of the Older Adult Patient with Anomalous Left Coronary Artery from the Pulmonary Artery Syndrome: A Presentation of Two Cases and Review of the Literature

Successful Intraoperative Identification of an Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Using Real Time Three-Dimensional Transesophageal Echocardiography

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