Long‑term outcome after surgical repair of anomalous origin of the left coronary artery from the pulmonary artery: 24 years of experience

Abstract

Statistical analysis Statistical analyses were performed using Wizard Pro 1.9.13 (Evan Miller, Chicago, Illinois, United States). Categorical variables were expressed as count (n) and percentages. Continuous variables were expressed as mean (SD) or median (minimum-maximum), depending on the distribution. Normality of the distribution was tested using the Shapiro-Wilk test. The paired t test and Wilcoxon signed-rank test were used for repeated measures, while the t test and the Mann-Whitney test were used for other cases. For multiple comparisons, proper analysis of variance or the Friedman test was used. Categorical data were compared using the χ 2 , McNemar, and Stuart-Maxwell tests for assessing changes over time. A P value of less than 0.05 was considered significant. Results and discussion Detailed preoperative characteristics are summarized in Supplementary material, Table S1.

Myocardial function in patients with anomalous left coronary artery from the pulmonary artery syndrome: A long-term speckle tracking echocardiographic study

“…Our study is the one with the longest follow-up concerning the ALCAPA patients operated in their early childhood, with the use of STE. The vast majority of patients remained in good clinical condition, normalized their LVEF, diastolic cardiac dimensions, and diminished the severity of mitral regurgitation without mitral valve surgery [15], similarly to what others have reported [2,13]. Despite no significant stenosis of the proximal LCA on color Doppler, detailed echocardiographic analysis revealed extensive abnormalities in comparison to the age, sex and BSA-matched control group.…”

“…The ALCAPA syndrome is a unique clinical model to study the influence of chronic hypoperfusion and subsequent reperfusion on the LV function, without the confounding effects of comorbidities, like hypertension, tobacco smoking, diabetes or dyslipidemia. One patient of whole 24-cases group under observation in our university hospital died suddenly 21 years after surgery—no abnormalities were present in her clinical status or standard echocardiographic examination at the last follow-up before death [15]. This case suggested that in this patient group standard follow-up parameters fail to identify patients at risk and the long-term postoperative prognosis is uncertain.…”

“…Clinical data of all patients with ALCAPA under observation in our Clinical Hospital between 1991 and 2014 (24 cases) are presented as a short communication in a separate publication [15]. Four patients of this study population died and 2 did not have detailed echocardiographic examination performed.…”

“…There was one late arrhythmic death due to ventricular fibrillation in an asymptomatic patient with normal LV function at the age of 21. This fact motivated us to invite all our ALCAPA patients for a detailed follow-up examination and to summarize these observations [15].…”

Left main coronary artery systolic compression by a dilated pulmonary artery: intravascular ultrasound assessment of the milking phenomenon

“…Left main coronary artery compression syndrome is a rare condition characterized by LMCA compression in -between the aorta and an enlarged main PA trunk, which could require revascularization. 1,2 It is more often associated with congenital heart diseases, particularly atrial septal defect, ventricular septal defect, patent ductus arteriosus, or tetralogy of Fallot. 3,4 The likelihood of significant myocardial ischemia depends both on the degree of LMCA compression and its angle with the left sinus of Valsalva (particularly if less than 30°).…”