ANOMALOUS ORIGIN OF THE LEFT CORONARY-ARTERY FROM THE PULMONARY-ARTERY - REPAIR BY AORTIC REIMPLANTATION

被引：15

作者：

NEIROTTI, R

NIJVELD, A

ITHURALDE, M

QUAGLIO, M

SEARA, C

LUBBERS, L

SCHULLER, J

MOLLEN, R

机构：

[1] Department of Pédiatrie Cardiac Surgery, Academical Medical Center, Amsterdam

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1991年 / 5卷 / 07期

关键词：

ANOMALOUS LEFT CORONARY ARTERY; MYOCARDIAL ISCHEMIA; MITRAL INCOMPETENCE; CORONARY REIMPLANTATION;

D O I：

10.1016/1010-7940(91)90054-N

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

From 1980 to 1990, 12 patients (mean age 2.5 years, range 5 months to 9 years) with anomalous origin of the left coronary artery from the pulmonary artery were treated surgically. Five infants were operated upon in the first year of life because of persistent symptoms of congestive heart failure. In all cases, a two-coronary system was constructed by direct aortic reimplantation of the anomalous vessel with no deaths early or late over a follow-up period of up to 10 years. The technique of reimplantation was facilitated by transection of the main pulmonary artery. One patient with severe mitral regurgitation underwent, in addition, a mitral annuloplasty. A pulmonary valvotomy was performed in another patient with associated pulmonary stenosis. Three patients are receiving medication. The reimplanted anomalous left coronary artery was patent in each reevaluated patient (10/12). Left ventricular function improved considerably in all cases. Patients with symptoms should undergo repair soon after diagnosis. Direct aortic reimplantation should be technically feasible in even the smallest infant. Operative mortality is related to preoperative conditions and severity of ischemic damage of the myocardium.

引用

页码：368 / 372

页数：5

共 20 条

[1]

Arciniegas E., Farooki Z.Q., Hakimi M., Green E., Management of anomalous left coronary artery from the pulmonary artery, Circulation, 62, pp. 180-189, (1980)

[2]

Bland E.F., White P.D., Garland J., Congénital anomalies of the coronary arteries: Report of an unusual case associated with cardiac hypertrophy, Am Heart J, 8, pp. 787-801, (1933)

[3]

Brooks H., Two cases of abnormal coronary artery of heart, J Anat Physiol, 20, pp. 26-28, (1986)

[4]

Bunton R., Jonas R.A., Lang P., Rein A.J., Castaneda A., Anomalous origin of left coronary artery from pulmonary artery, J Thorac Cardiovasc Surg, 93, pp. 103-108, (1987)

[5]

Driscoll D.J., Nihill M.R., Mullins C.E., Cooley D.A., McNamara D.G., Management of symptomatic infants with anomalous origin in the left coronary artery from the pulmonary artery, Am J Cardiol, 47, pp. 642-648, (1981)

[6]

Edwards J.E., The direction of blood flow in coronary arteries arising from the pulmonary trunk, Circulation, 29, pp. 163-166, (1964)

[7]

Guikahue M.K., Sidi D., Kachaner J., Villain E., Cohen L., Piechaud J.F., Le Bidois J., Pedroni E., Vouhe P., Neveux J.I., Anomalous left coronary artery arising from the pulmonary artery in infancy: Is early operation better?, Br Heart J, 60, (1988)

[8]

Harthorne J.W., Scannell J.G., Dinsmore R.E., Anomalous origin of the left coronary artery: Remediable cause of sudden death in adults, N Engl J Med, 275, pp. 660-664, (1966)

[9]

Kirklin J.W., Barrat-Boyes B.G., (1986) Congénital anomalies of the coronary arteries, Cardiac Surgery, pp. 945-969

[10]

Laborde F., Marchand M., Leca F., Jarreau M.M., Dequirot A., Hazan E., Surgical treatment of anomalous origin of the left coronary artery in infancy and childhood, J Thorac Cardiovasc Surg, 82, pp. 423-428, (1981)

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