Surgical treatment of anomalous left coronary artery from pulmonary artery: Follow-up in teenagers and adults

Wilson, Charles L.; Dlabal, Paul W.; McGuire, Stephen A.

doi:10.1016/0002-8703(79)90248-5

Cited by 68 publications

(33 citation statements)

References 40 publications

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“…The high risk of sudden death, even in asymptomatic patients, warrants surgical correction of the anomaly when diagnosed (29,30). Many techniques for surgical correction have been utilized: ligation of the left main coronary artery (31,32), left main coronary ligation combined with bypass grafting (3 1,33), construction of a baffle from the left coronary artery to the aorta (34), left coronary artery to subclavian artery anastomosis (35), re-implantation of the coronary artery into the aorta (3 1,36), or tunneling from the aorta to left coronary artery using a tissue flap from the pulmonary artery (37,38). The type of surgical procedure may be dictated by the age of the patient and other…”

Section: Potentially Serious Coronary Anomaliesmentioning

confidence: 99%

Coronary artery anomalies in 126,595 patients undergoing coronary arteriography

Yamanaka¹,

Hobbs²

1990

Cathet. Cardiovasc. Diagn.

1,864

1,599

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Coronary artery anomalies were found in 1,686 patients (1.3% incidence) undergoing coronary arteriography at the Cleveland Clinic Foundation from 1960 to 1988. Of the 1,686 patients, 1,461 (87%) had anomalies of origin and distribution, and 225 (13%) had coronary artery fistulae. Most coronary anomalies did not result in signs, symptoms, or complications, and usually were discovered as incidental findings at the time of catheterization. Eighty-one percent were "benign" anomalies: 1) separate origin of the left anerior descending and circumflex from the left sinus of Valsalva; 2) ectopic origin of the circumflex from the right sinus of Valsalva; 3) ectopic coronary origin from the posterior sinus of Valsalva; 4) anomalous coronary origin from the ascending aorta; 5) absent circumflex; 6) intercoronary communications; and 7) small coronary artery fistulae. Other anomalies may be associated with potentially serious sequelae such as angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure, or sudden death. Potentially serious anomalies include: 1) ectopic coronary origin from the pulmonary artery; 2) ectopic coronary origin from the opposite aortic sinus; 3) single coronary artery; and 4) large coronary fistulae. Coronary artery anomalies require accurate recognition, and at times, surgical correction.

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Section: Potentially Serious Coronary Anomaliesmentioning

confidence: 99%

Coronary artery anomalies in 126,595 patients undergoing coronary arteriography

Yamanaka¹,

Hobbs²

1990

Cathet. Cardiovasc. Diagn.

1,864

1,599

View full text Add to dashboard Cite

show abstract

“…Bu anomali ile doğan çocukların %90'ı tedavi edilmezse ilk yıl içerisinde konjestif kalp yetmezliği (KKY) nedeniyle yaşamlarını yitirir. [1,2] İki yaşın altında KKY gelişen çocukların önemli bir kısmında nedenin ALCAPA olduğu, %80'den fazlasında semptomların yenidoğan ve erken bebeklik (infancy) döneminde ortaya çıktığı bildirilmiştir. [1][2][3][4][5] Bebeklik döneminde görülen dilate kardiyomiyopatilerin ayırıcı tanısında, tedavi edilebilir bir kardiyomiyopati nedeni olarak koroner arter anomalileri ve ALCAPA'nın dikkatle araştırılması büyük bir önem taşımaktadır.…”

Section: Discussionunclassified

“…[1,2] İki yaşın altında KKY gelişen çocukların önemli bir kısmında nedenin ALCAPA olduğu, %80'den fazlasında semptomların yenidoğan ve erken bebeklik (infancy) döneminde ortaya çıktığı bildirilmiştir. [1][2][3][4][5] Bebeklik döneminde görülen dilate kardiyomiyopatilerin ayırıcı tanısında, tedavi edilebilir bir kardiyomiyopati nedeni olarak koroner arter anomalileri ve ALCAPA'nın dikkatle araştırılması büyük bir önem taşımaktadır. [4,[6][7][8][9] Olguların çoğunda, sol ana koroner arter (sol ana KA), pulmoner arterin sol lateral sinüsünden çıkmaktadır.…”

Section: Discussionunclassified

“…ligasyondan sonra sol ventrikül fonksiyonlarında düzel-me ve kardiyomegalide küçülme bildirilmesine rağmen, elektrokardiyografi (EKG) ve treadmill testlerinin anormal kaldığı, geç dönemde ani ölüm olasılığının yüksek olduğu gözlenmiştir. [1,2,5] Subklaviyan arterin koroner artere anastomozu tekniği geçmişte kullanılmıştır ancak gerilme veya büzülme ihtimali ve sağlam bir koroner artere anastomoz uygulanması gibi nedenler bu tekniğin dezavantajını oluşturmaktadır. [3,5,10] Reimplantasyon tekniği ile mükemmel sonuçlar bildirilmiştir.…”

Section: Discussionunclassified

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Anomalous left coronary artery originating from pulmonary artery: recovery of left ventricular function after dual coronary system restoration and clinical results

Sarıoğlu¹

2013

Turk Gogus Kalp Dama

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“…There seems to be a general consensus that establishing a two coronary artery system is preferable to assure adequate myocardial perfusion. [1][2][3][4][5][6][7] To aid in the evaluation of cardiac function of patients with anomalous origin of the left coronary from the pulmonary artery, this study evaluated the exercise performance of a group of patients who had undergone surgical repair of this defect. We evaluated both myocardial performance and, using thallium 201 scintigraphy, postoperative myocardial perfusion.…”

mentioning

confidence: 99%

Exercise performance after repair of anomalous origin of the left coronary artery from the pulmonary artery.

et al. 1990

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Eleven patients underwent exercise testing after operative repair of anomalous origin of the left coronary artery from the pulmonary artery. Five patients repaired after 2 years of age comprised a childhood surgery group, and six patients repaired before 2 years of age comprised an infant surgery group. All patients were exercised using either a treadmill or electronically braked bicycle with simultaneous thallium 201 scintigraphy. Oxygen consumption, carbon dioxide production, pulmonary functions, and electrocardiogram were all monitored continuously. Pulmonary reserve was normal in all patients. Based on heart rate reserve, respiratory exchange ratio, and oxygen-consumption response to work load, two patients in the infant surgery group stopped exercise before achieving maximum aerobic capacity. All remaining patients achieved their maximum aerobic capacity. There was no difference in work rate or oxygen consumption during exercise between the infant and childhood surgical group. Four patients (two in each surgical group) had an impaired chronotropic response to exercise. Three of these four patients demonstrated perfusion defects by thallium scintigraphy. Thallium scintigraphy was normal in all remaining patients. Electrocardiographic abnormalities were noted in seven of 11 patients having ventricular arrhythmias or ST segment depression. It is concluded from this study that exercise performance after repair of anomalous origin of the left coronary artery from the pulmonary artery is not affected by the age at which surgery is performed. Exercise is frequently associated with electrocardiographic evidence of abnormal myocardial perfusion despite frequently negative simultaneous 201TI scintigraphy. (Circulation 1990;81:1287-1292 Anomalous left coronary artery arising from the pulmonary artery is a rare defect explaining fewer than 0.1% of new cases of congenital heart disease. It frequently results in congestive heart failure secondary to myocardial ischemia and subsequent infarction in early infancy.' The need for surgery, the timing of surgery, and the type of operation for these patients have been debated for years. There seems to be a general consensus that establishing a two coronary artery system is preferable to assure adequate myocardial perfusion.1-7To aid in the evaluation of cardiac function of patients with anomalous origin of the left coronary from the pulmonary artery, this study evaluated the exercise performance of a group of patients who had undergone surgical repair of this defect. We evaluated From the Divisions

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Surgical treatment of anomalous left coronary artery from pulmonary artery: Follow-up in teenagers and adults

Cited by 68 publications

References 40 publications

Coronary artery anomalies in 126,595 patients undergoing coronary arteriography

Coronary artery anomalies in 126,595 patients undergoing coronary arteriography

Anomalous left coronary artery originating from pulmonary artery: recovery of left ventricular function after dual coronary system restoration and clinical results

Exercise performance after repair of anomalous origin of the left coronary artery from the pulmonary artery.

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