Reimplantation of Anomalous Left Coronary Artery From the Pulmonary Artery Without Mitral Valve Repair

Caspi, Joseph; Pettitt, Timothy W.; Sperrazza, Charles; Mulder, Theodorus; Stopa, Aluizio

doi:10.1016/j.athoracsur.2007.03.036

Cited by 39 publications

(48 citation statements)

References 18 publications

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“…The overall long-term survival of this series was 92.3%, which was similar to that in other reports concerning direct LCA reimplantation for ALCAPA (91-100%) and was much better than those in patients treated with other surgical methods (70-86%) [3,4,14,17]. About a quarter of our patients developed supravalvular pulmonary stenosis, but only of a mild degree.…”

Section: Discussionsupporting

confidence: 88%

“…This might be related to small patient numbers in all of the studies. The severity of preoperative MR, presence of LV dysfunction and younger age were the most frequently reported risk factors [3,4,11,13,17]. In this study, only one patient aside from the mortality case had improved, but still showed persistently low LVEF after one-year follow-up.…”

Section: Discussionmentioning

confidence: 59%

“…But, without concomitant mitral annuloplasty, they also found that 12.5% of the patients exhibited significant MR and 5.4% of the patients underwent mitral valve replacement 1 to 13 months after the surgery for ALCAPA. In contrast, some studies found a time lag in MR improvement as compared to the recovery of LV function [3,4,6]. In our patients with moderate to severe MR, concomitant mitral annuloplasty was carried out, which might have prompted the recovery of MR.…”

Section: Discussionmentioning

confidence: 73%

“…From previous studies, risk factors for persistently poor LV function or operative mortality varied and were even contradictory [3,4,7,13,17]. This might be related to small patient numbers in all of the studies.…”

Section: Discussionmentioning

confidence: 77%

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Resolution of pathologic Q wave, left ventricular dysfunction and mitral regurgitation after dual coronary repair of the anomalous origin of the left coronary artery from the pulmonary artery

et al. 2008

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac defect that usually presents as dilated cardiomyopathy in infancy. From 1984 to 2005, 13 (five males and eight females, 0.13%) out of 9,950 patients with congenital heart disease were identified as ALCAPA at our institute. Corrective surgery was performed at a median age of 9 months (range: 2 months to 5 years). Eleven patients underwent direct reimplantation of the left coronary artery (LCA) to the aorta, while two received extrapulmonary baffling. The overall survival rate was 92%. Only one patient died 5 months after reimplantation of the LCA due to acute myocardial ischaemia. Left ventricular ejection fraction (LVEF) was significantly lower in the eight (62%) patients operated during infancy than in those operated beyond 5 months (median: 35% vs. 75%). Left ventricle function was normalised in 11 patients (85%). Among the eight patients without concomitant mitral annuloplasty, mitral regurgitation (MR) improved to a mild or trivial degree in six patients and remained at the pre-operative level in two patients. Pathologic Q wave was noted in 11 patients, which eventually regressed in all except two cases. The median interval of recovery was 16 days, 6 months and 24 months for MR, LVEF and electrocardiogram (ECG) changes, respectively. In conclusion, ALCAPA is also a rare disease in Asian countries, such as Taiwan. The subsequent recovery of MR, left ventricular (LV) function and even pathologic Q wave can be expected after dual coronary repair, regardless of the age at repair.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 77%

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Resolution of pathologic Q wave, left ventricular dysfunction and mitral regurgitation after dual coronary repair of the anomalous origin of the left coronary artery from the pulmonary artery

et al. 2008

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“…A broad agreement has been reached to advocate (1) restoration of a two-vessel coronary system by direct aortic reimplantation of the anomalous artery [2][3][4] and (2) early surgery to promote rapid recovery of left ventricular function [5][6][7]. There remains, however, some discussion regarding the management of associated mitral regurgitation and the need for concomitant mitral valve repair [8][9][10].…”

Section: Introductionmentioning

confidence: 95%

Anomalous origin of the left coronary artery from the pulmonary artery: late results with special attention to the mitral valve☆

Ali

Metton

Roubertie

et al. 2009

European Journal of Cardio-Thoracic Surgery

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(1) Early mortality is related to the severity of preoperative left ventricular dysfunction; it may be reduced by a careful use of postoperative cardiac support techniques. (2) Late results are satisfactory and left ventricular function always recovers. (3) Mitral regurgitation improves along with left ventricular function, but recovery may be incomplete and need reoperation. The data suggest that mitral valve surgery is probably not indicated at initial surgery, except in selected cases with a low potential of recovery (severe regurgitation with relatively well-preserved left ventricular function).

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Anomalous left coronary artery arising from the pulmonary artery discovered beyond infancy

Zheng

Han

Chen

et al. 2015

J of Clinical Ultrasound

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a congenital heart defect rarely diagnosed beyond infancy. We present a 9-year-old girl who had once been diagnosed as congenital coronary artery fistula. Echogenic mitral chordae tendineae, multiple coronary collaterals within the ventricular septum and free ventricular wall, and a shunting flow from the left coronary artery into the pulmonary artery were prominent echocardiographic features of ALCAPA. Reimplantation of the left coronary artery directly onto the aorta achieved a favorable outcome with regression of left ventricular size and alleviation of mitral regurgitation.

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Reimplantation of Anomalous Left Coronary Artery From the Pulmonary Artery Without Mitral Valve Repair

Cited by 39 publications

References 18 publications

Resolution of pathologic Q wave, left ventricular dysfunction and mitral regurgitation after dual coronary repair of the anomalous origin of the left coronary artery from the pulmonary artery

Resolution of pathologic Q wave, left ventricular dysfunction and mitral regurgitation after dual coronary repair of the anomalous origin of the left coronary artery from the pulmonary artery

Anomalous origin of the left coronary artery from the pulmonary artery: late results with special attention to the mitral valve☆

Anomalous left coronary artery arising from the pulmonary artery discovered beyond infancy

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