HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vigneswaran, W. T. Articles by Clarke, D. R. Search for Related Content PubMed PubMed Citation Articles by Vigneswaran, W. T. Articles by Clarke, D. R.

The Annals of Thoracic Surgery, Vol 48, 560-564, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Evolution of the management of anomalous left coronary artery: a new surgical approach

WT Vigneswaran, DN Campbell, G Pappas, JW Wiggins, RW Wolfe and DR Clarke
Department of Cardiothoracic Surgery, Children's Hospital, Denver, Colorado.

Twelve patients with anomalous left coronary artery (LCA) from the pulmonary artery were treated surgically. Mean age was 13 months and mean weight, 7.7 kg. One of the following techniques was used in 8 patients: suture obliteration of the coronary orifice, ligation of the anomalous LCA and grafting of the internal mammary artery to the distal LCA, aortic reimplantation of the anomalous LCA, creation of an aortopulmonary window, and direct anastomosis to the right subclavian artery. In 4 patients, a new technique to establish a two-coronary artery system involved tube extension of the anomalous LCA with pulmonary artery wall and then anastomosis to the right subclavian artery using cardiopulmonary by-pass without aortic cross-clamping. There were two hospital deaths (17%) and one late death. The condition of the 9 long-term survivors was improved at late follow-up. Postoperative assessment showed smaller Q wave on the electrocardiogram, reduced cardiac size, and good left ventricular function. All patients in whom the repair was done using the new technique were free from postoperative cardiac complications, had shortened hospital stays, and were alive with a patent two-coronary artery system at late follow-up. We believe this approach is a safer method for establishing a two-coronary artery system in infants and small children with an anomalous LCA arising from the pulmonary artery.

This article has been cited by other articles:

				R. Lange, M. Vogt, J. Horer, J. Cleuziou, A. Menzel, K. Holper, J. Hess, and C. Schreiber Long-Term Results of Repair of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery Ann. Thorac. Surg., April 1, 2007; 83(4): 1463 - 1471. [Abstract] [Full Text] [PDF]

				G. Michielon, D. Di Carlo, G. Brancaccio, P. Guccione, E. Mazzera, A. Toscano, and R. M. Di Donato Anomalous coronary artery origin from the pulmonary artery: correlation between surgical timing and left ventricular function recovery Ann. Thorac. Surg., August 1, 2003; 76(2): 581 - 588. [Abstract] [Full Text] [PDF]

				A. Dodge-Khatami, C. Mavroudis, and C. L. Backer Anomalous origin of the left coronary artery from the pulmonary artery: collective review of surgical therapy Ann. Thorac. Surg., September 1, 2002; 74(3): 946 - 955. [Abstract] [Full Text] [PDF]

				A. D. Cochrane, D. M. Coleman, A. M. Davis, C. P. Brizard, MD, R. Wolfe, PhD, and T. R. Karl EXCELLENT LONG-TERM FUNCTIONAL OUTCOME AFTER AN OPERATION FOR ANOMALOUS LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY J. Thorac. Cardiovasc. Surg., February 1, 1999; 117(2): 332 - 342. [Abstract] [Full Text] [PDF]

				S. Sivasubramanian and J. D. Waldman Pulmonary Atresia, IVS, and RV-CAC: Can CABG Alter Choice of Repair? Ann. Thorac. Surg., September 1, 1996; 62(3): 949 - 950. [Full Text]

				V. Alexi-Meskishvili, R. Hetzer, Y. Weng, P. E. Lange, Z. Jin, F. Berger, and M. Loebe Anomalous origin of the left coronary artery from the pulmonary artery: Early results with direct aortic reimplantation J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 354 - 362. [Abstract] [Full Text]