Korean J Thorac Cardiovasc Surg.  2014 Jun;47(3):220-224.

An Alternative Surgical Technique for Repair of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

• Kim YS
• Lee M
• Cho YH
• Yang JH
• Jun TG

Abstract

BACKGROUND
For the surgical management of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), there have been various techniques that reduce the tension and kinking of the coronary artery during reimplantation to the aorta. The aim of this study is to describe the results of our modified technique of coronary reimplantation for the treatment of ALCAPA.
METHODS
Between October 2003 and February 2011, seven patients underwent coronary reimplantation with the modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta). The median follow-up duration was 52 months (range, 4 to 72 months). Clinical outcomes and serial echocardiographic data were reviewed.
RESULTS
There was no mortality. One patient had a small amount of cerebral hemorrhage postoperatively and improved without any sequelae. Another patient had left diaphragm palsy and underwent diaphragm plication. Follow-up echocardiogram showed that all patients had normal ventricular function without chamber enlargement.
CONCLUSION
Our modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta) demonstrated successful clinical outcomes. We conclude that this surgical technique can be a potential alternative for the treatment of ALCAPA.

Keyword

Coronary vessel anomalies; Bland white Garland syndrome; Replantation; Congenital heart disease

MeSH Terms

Aorta
Bland White Garland Syndrome
Cerebral Hemorrhage
Coronary Vessel Anomalies
Coronary Vessels*
Diaphragm
Echocardiography
Follow-Up Studies
Heart Defects, Congenital
Humans
Mortality
Paralysis
Pulmonary Artery*
Replantation
Ventricular Function