Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug 26;11(1):137.
doi: 10.1186/s13019-016-0535-7.

Midterm outcome after surgical correction of anomalous left coronary artery from the pulmonary artery

Yunfei Ling  1 , Sandeep Bhushan  1 , Qiang Fan  1 , Menglin Tang  2
Affiliations

Midterm outcome after surgical correction of anomalous left coronary artery from the pulmonary artery

Yunfei Ling et al. J Cardiothorac Surg. .

Abstract

Background: This study was undertaken to determine the midterm outcome in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) undergoing coronary reimplantation and Takeuchi repair.

Methods: A retrospective review of patients who had ALCAPA repair between January 2009 and December 2015. Mortality, echocardiography assessment of left ventricular function including ejection fractionand, shortening fraction, severity of mitral regurgitation, stenosis of the coronary ostium were studied retrospectively.

Results: Sixteen patients were described. The mean age at the time of surgery was 22.5 ± 10.3 years (range, 9 months-35.6 years) and 2 patients were younger than 1 year old, Surgical interventions included left coronary artery reimplantation in 13 patients (81 %) and Takeuchi repair in 3 (19 %). Concomitant mitral valve repair was performed in 2 cases, no cases required mechanical circulatory support postoperatively. There was no mortality. At median follow-up of 4.6 years, EF improved from 33.2 % ±6.8 % to 60.9 % ± 8.1 % (p <0.05), mean SF from 28.5 % ± 12.1 % to 40.2 % ± 5.4 % (p <0.05). Only one patient was with moderate mitral regurgitation. All 16 cases had normal ejection fraction and shortening fraction without stenosis of the coronary ostium at last follow-up.

Conclusions: Early establishment of a 2-coronary artery achieved excellent outcomes without morbidity and mechanical circulatory support. Normal ejection fraction and shortening fraction recovered smoothly. There is no stenosis of the coronary ostium at the midterm follow-up.

Keywords: Anomalous coronary artery from pulmonary artery; Coronary artery reimplantation; Outcome; Surgical correction.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
ALCAPA in an infant: TTE showed the LCA originating from the pulmonary artery
Fig. 2
Fig. 2
ALCAPA in an adult before the surgery: Coronariograms revealed a tortuous and dilated RCA as well as an equally tortuous and dilated LCA and well-established collateral vessels between LCA and RCA
Fig. 3
Fig. 3
After the surgical correction of ALCAPA. Coronariograms revealed LCA arising from the AAO and well-established collateral vessels between LCA and RCA
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Dodge-Khatami A, Mavroudis C, Backer CL. Anomalous origin of the left coronary artery from the pulmonary artery: collective review of surgical therapy. Ann Thorac Surg. 2002;74(3):946–955. doi: 10.1016/S0003-4975(02)03633-0. - DOI - PubMed
    1. Wu QY, Xu ZH. Surgical treatment of anomalous origin of coronary artery from the pulmonary artery. Chin Med J. 2008;121(8):721–724. - PubMed
    1. Erdinc M, Hosgor K, Karahan O. Repair of anomalous origin of the left coronary artery arising from right pulmonary artery with rolled-conduitextended reimplantation in an adult. J Card Surg. 2011;26(6):604–607. doi: 10.1111/j.1540-8191.2011.01337.x. - DOI - PubMed
    1. Peña E, Nguyen ET, Merchant N, Dennie C. ALCAPA Syndrome: not just a pediatric disease 1. Radiographics. 2009;29(2):553–565. doi: 10.1148/rg.292085059. - DOI - PubMed
    1. Cabrera AG, Chen DW, Pignatelli RH, Khan MS, Jeewa A, Mery CM, et al. Outcomes of anomalous left coronary artery from pulmonary artery repair: beyond normal function. Ann Thorac Surg. 2015;99(4):1342–1347. doi: 10.1016/j.athoracsur.2014.12.035. - DOI - PubMed

LinkOut - more resources