ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pandey, R.
Right arrow Articles by Pozzi, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pandey, R.
Right arrow Articles by Pozzi, M.
Related Collections
Right arrow Congenital - acyanotic

Ann Thorac Surg 2002;74:1625-1630
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Anomalous origin of the left coronary artery from the pulmonary artery: results of surgical correction in five infants

Ragini Pandey, FRCS (Ed)a, Giovanna Ciotti, MDa, Marco Pozzi, MDa*

a Cardiac Unit, Royal Liverpool Children’s Hospital, Alder Hey, Liverpool, United Kingdom

Accepted for publication May 29, 2002.

* Address reprint requests to Dr Pozzi, Cardiac Unit, Royal Liverpool Children’s Hospital, Alder Hey, Eaton Rd, Liverpool L12 2AP, UK.
e-mail: mpozzi75{at}hotmail.com

BACKGROUND: Five infants operated on for anomalous origin of the left coronary artery from the pulmonary artery were retrospectively analyzed. The mean age at operation was 12 ± 6.7 weeks (95% confidence interval, 3.5 to 20 weeks), and mean weight at operation was 4.43 ± 0.68 kg (95% confidence interval, 3.7 to 5.27 kg). All babies presented in infancy with left ventricular failure. Three had evidence of ischemia with left ventricular strain, and two had Q waves in anterolateral leads on electrocardiograph. Cross-sectional echocardiography showed dilated left ventricles with poor contractility in all babies with fractional shortening of 15.8% ± 4.02% (95% confidence interval, 12% to 20%); moderate mitral regurgitation was seen in all babies.

METHODS: All babies underwent operation as soon as the diagnosis was made. Four babies had direct reimplantation of left coronary artery into the aorta, and 1 had tunnel repair. Intraaortic balloon counterpulsation was used in 1 baby for hemodynamic instability and as prophylaxis in the remaining 4 babies postoperatively for 115 ± 26.2 hours (95% confidence interval, 72 to 144 hours).

RESULTS: All babies had delayed closure of the chest. There was no operative mortality. One baby was reoperated on for tunnel stenosis as well as pulmonary stenosis 4 months after primary repair. All babies were followed for 192 patient-months and show an improved fractional shortening.

CONCLUSIONS: Early operation, early institution of intraaortic balloon counter pulsation for left ventricular support, and delayed sternal closure are the key to good results.




This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
G. Kalavrouziotis, A. Karunaratne, S. Raja, G. Ciotti, M. Purohit, A. F. Corno, and M. Pozzi
Intra-aortic balloon pumping in children undergoing cardiac surgery: An update of the Liverpool experience
J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1382 - 1389.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The Society of Thoracic Surgeons.