Anomalous Coronary Artery From the Wrong Sinus of Valsalva: A Physiologic Repair Strategy

Alphonso, Nelson; Anagnostopoulos, Petros V.; Nölke, Lars; Moon-Grady, Anita J.; Azakie, Anthony; Raff, Gary W.; Karl, Tom R.

doi:10.1016/j.athoracsur.2006.10.071

Cited by 45 publications

(37 citation statements)

References 16 publications

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“…This condition is believed by many to be another factor contributing to ischemia as a result of compression of LMCA between the great vessels. 3,6,7,14 In our case, we had to transect the main pulmonary artery to be able to have a clear vision during the unroofing procedure of LMCA. We were also concerned about the possible compression of the unroofed part of LMCA by the pulmonary artery when it was reapproximated.…”

Section: Commentmentioning

confidence: 95%

“…After transection of the main pulmonary artery, they translocated the proximal pulmonary artery to the left pulmonary artery with patch augmentation of the bifurcation and the right pulmonary artery. 14 We feel that elongation of the main pulmonary artery without lateral translocation is simpler, and we believe it to be sufficient to reduce the likelihood of hemodynamically important compression of the coronary artery between the aorta and pulmonary trunk.…”

Section: Commentmentioning

confidence: 96%

“…14 In this group of patients, despite technical challenges, direct coronary reconstruction by unroofing the ostium and proximal part of LCA may be a reasonable surgical technique instead of bypass grafting, because there are some concerns about competitive flow and long-term patency of bypass to a coronary artery that is unobstructed or minimally obstructed under nonstressed conditions. 3,6,7,13 Our patient remains asymptomatic and the treadmill test is negative for evidence of myocardial ischemia in the postoperative year 2.…”

Section: Commentmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Repair of a Cause of Sudden Death

Sarıoğlu

Yalçınbaş

Erek

et al. 2011

World J Pediatr Congenit Heart Surg

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Left coronary artery originating from the right coronary sinus is one of the most frequent causes of sudden death in young people. We present a reconstructive surgical technique for left coronary artery and main pulmonary artery in a case with anomalous origin of the left coronary artery from the right coronary sinus. A 15-year-old boy underwent unroofing of the left main coronary artery and patch arterioplasty with autologous pericardium after transection of the main pulmonary artery. The pulmonary artery was reconstructed with autologous pericardium and a piece of dacron patch in order to prevent coronary artery compression. This surgical approach resulted in successful clinical outcome.

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Section: Commentmentioning

confidence: 95%

Section: Commentmentioning

confidence: 96%

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Repair of a Cause of Sudden Death

Sarıoğlu

Yalçınbaş

Erek

et al. 2011

World J Pediatr Congenit Heart Surg

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show abstract

“…Table 1 summarizes the results from the largest surgical series for treatment of AAOCA available in the literature. 30,[33][34][35][36][37][38][39][40] The complication rate is reported to be 7%-20% with no operative mortality. Long-term results have overall been good although up to 15% of patients may have symptoms postoperatively.…”

Section: Coronary Artery Bypass Graft Surgerymentioning

confidence: 98%

Anomalous Aortic Origin of a Coronary Artery: Toward a Standardized Approach

Mery

Lawrence

Krishnamurthy

et al. 2014

Seminars in Thoracic and Cardiovascular Surgery

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“…Surgery consisted of an ostial plasty of the LMCA to widen the proximal 7 mm of the coronary artery. Additionally, a lateral pulmonary translocation was performed to decompress the interarterial segment [11]. Because of a narrow relation between the coronary ostia and the commissure, unroofing or coronary re-implantation were considered inadequate techniques as corrective procedures.…”

Section: Case Reportmentioning

confidence: 99%

Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course

et al. 2012

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Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction. We reviewed the literature to establish an evidence-based recommendation to aid physicians in conducting the optimal pre-sport participation management for the prevention of SCD in patients with a surgically corrected AAOCA/ ALCA, especially for those who participate in strenuous exercise. Review of the literature (60 articles with 325 patients) reveals that post-surgical, pre-sport participation testing varies greatly but that mortality after surgical repair is extremely low (1.5 %). In conclusion, SCD can still rarely occur after repair of AAOCA despite extensive pre-sport participation testing. This should raise awareness among physicians treating these patients and raises the question whether or not return-to-play guidelines need to be revised.

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Anomalous Coronary Artery From the Wrong Sinus of Valsalva: A Physiologic Repair Strategy

Cited by 45 publications

References 16 publications

Surgical Repair of a Cause of Sudden Death

Surgical Repair of a Cause of Sudden Death

Anomalous Aortic Origin of a Coronary Artery: Toward a Standardized Approach

Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course

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