Surgical Outcomes for Children with Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

Wang, Zhangwei; Ding, Nan; Zhang, Jinrui; Zhu, Yaobin; Li, Zhiqiang; Li, Xiaofeng

doi:10.1007/s00246-022-02964-3

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…However, it has been debated whether ACAPA patients with different degrees of mitral valve regurgitation (MVR) require mitral valve plasty (MVP) concurrently with the coronary repair. Some researchers considered that mitral valve function would be improved after recovery of left ventricular (LV) function without any intervention [ 7 , 8 , 9 ], some researchers thought that moderate or severe MVR with structural abnormalities requires simultaneous management [ 10 ], and others recommended concomitant MVP at the initial operation even with a mild MVR [ 11 ].…”

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confidence: 99%

Effectiveness and Safety of Mitral Valve Plasty in Patients with an Anomalous Origin of the Coronary Artery from the Pulmonary Artery

Lang

Zhang

et al. 2023

JCDD

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The study aimed to determine the effectiveness and safety of anomalous coronary artery from pulmonary artery (ACAPA) patients with moderate or severe mitral valve regurgitation (MVR) receiving mitral valve plasty (MVP) concurrently. Consecutive ACAPA patients undergoing surgery between 2015 and 2021 were retrospectively included. Patients were divided into three groups: moderate MVR without MVP (non-MVP (moderate) N = 14), moderate MVR with MVP (MVP (moderate) N = 13), and severe MVR with MVP (MVP (severe) N = 13). The primary safety endpoint was in-hospital surgery-related complications. The primary effectiveness outcome was left ventricular ejection function (LVEF) and left ventricular end-diastolic diameter (LVEDD) z-score at 2- and 24-month follow-ups. Multivariable linear regression models were used to obtain the β coefficient. The median age of the included patients was 7.5 years (IQR 1.4–26.5). The in-hospital surgery-related complication rates were 7.1%, 15.4%, and 7.7% in non-MVP (moderate), MVP (moderate), and MVP (severe) groups, separately. At the 2-month follow-up, the non-MVP (moderate) group had a better LVEF and LVEDD z-score compared with the MVP (moderate) group (LVEF β = 9.22, 95%CI 1.09 to 17.35; LVEDD z-score β = −2.49, 95%CI −4.53 to −0.45). At the 24-month follow-up, the LVEF of all patients and the LVEDD z-score of 90% of patients in the three groups returned to normal. For ACAPA patients with moderate MVR, MVP was not necessary, especially for pediatric patients (age < 3 years) and patients with secondary MVR. Further studies for ACAPA patients with severe MVR are still needed.

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