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The Annals of Thoracic Surgery, Vol 54, 732-740, Copyright © 1992 by The Society of Thoracic Surgeons
ED Fernandes, H Kadivar, GL Hallman, GJ Reul, DA Ott and DA Cooley
Coronary artery anomalies, some of which are considered clinically
insignificant, can be associated with other congenital heart defects,
myocardial ischemia, and reduced life expectancy. We conducted a
retrospective study to determine the efficacy of surgical treatment in 191
patients who had a total of 202 coronary artery anomalies, which were
classified as anomalies of origin (88 patients), termination (93), or
distribution (10). Of the 88 patients with anomalies of origin, 60 had a
coronary artery arising from the pulmonary artery, 18 had a right coronary
artery arising from the left anterior descending artery, and 10 had a
coronary artery arising from the contralateral sinus of Valsalva. All
patients with an anomaly of termination had a coronary arteriovenous
fistula, and all patients with an anomaly of origin had a single coronary
artery. The diagnostic and operative techniques for each of the defects are
evaluated. Based on our experience, early diagnosis and surgical
intervention can yield satisfactory results in patients with coronary
artery anomalies, with most experiencing relief of symptoms. The operative
procedures were associated with a low early and late mortality; in
addition, few patients experienced complications.
ARTICLES
Congenital malformations of the coronary arteries: the Texas Heart Institute experience
Department of Cardiovascular Surgery, Texas Heart Institute, Houston.
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