Repair of anomalous origin of the left coronary artery in the infant and small child

• Published in: Journal of the American College of Cardiology Vol. 4; no. 6; pp. 1231 - 1234
• Main Authors: Midgley, Frank M., Watson, Donald C., Scott, Lewis P., Kuehl, Karen S., Perry, Lowell W., Galioto, Frank M., Ruckman, Roger N., Shapiro, Stephen R.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.1984; Elsevier Science
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Child, Preschool; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Coronary Circulation; Coronary Vessel Anomalies - physiopathology; Coronary Vessel Anomalies - surgery; Female; Follow-Up Studies; Heart; Humans; Infant; Medical sciences; Pulmonary Artery - surgery; Time Factors; Human; Anomalous origin of the left coronary artery; Corrective surgery; Malformation; Coronary artery; Cardiovascular disease; Infant; Coronary heart disease; Child; Pulmonary artery
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(84)80142-4

Anomalous origin of the left coronary artery from the pulmonary artery is associated with myocardial infarction, left ventricular dysfunction, mitral valve dysfunction and, occasionally, intracardiac congenital abnormalities. A technique that utilizes a flap of the anterior wall of the pulmonary artery to serve as a neocoronary artery to direct aortic flow from a created aortopulinonary window to the pulmonary artery orifice of the anomalous left coronary artery was used in five patients aged 2.5 months to 4.75 years. Two patients were less than 4 months of age at operation. There was one death 2 days after operation and one late death. The two youngest patients required mitral valve replacement. Two of the three surviving patients are well at follow-up at 7 to 44 months. One patient has been lost to follow-up study. One patient had postoperative catheterization which showed an intact repair. The pulmonary artery neocor-onary procedure is applicable to infants and small patients with anomalous origin of the left coronary artery from the pulmonary artery.