A Novel Aortic Reconstruction for Anomalous Left Coronary Arising From the Right Pulmonary Artery in Hypoplastic Left Heart Syndrome: Successful Surgical Treatment

• Published in: Seminars in thoracic and cardiovascular surgery 2018, Vol.30 (4), p.456-459
• Main Authors: Konuma, Takeshi, Sakamoto, Syunsuke, Toba, Syuhei, Shimpo, Hideto
• Format: Article
• Language: English
• Subjects: Anomalous left coronary arising from the pulmonary artery; Aorta - abnormalities; Aorta - diagnostic imaging; Aorta - physiopathology; Aorta - surgery; Aortography - methods; Bland White Garland Syndrome - diagnostic imaging; Bland White Garland Syndrome - physiopathology; Bland White Garland Syndrome - surgery; bronchomalacia; Computed Tomography Angiography; Coronary Angiography - methods; Fontan Procedure; Humans; Hypoplastic left heart syndrome; Hypoplastic Left Heart Syndrome - diagnostic imaging; Hypoplastic Left Heart Syndrome - physiopathology; Hypoplastic Left Heart Syndrome - surgery; Infant; Infant, Newborn; Male; Norwood Procedures; PA trunk-saving method; Pulmonary Artery - abnormalities; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - physiopathology; Pulmonary Artery - surgery; Reconstructive Surgical Procedures - methods; tracheomalacia; Treatment Outcome; Vascular Surgical Procedures - methods
• ISSN: 1043-0679; 1532-9488
• DOI: 10.1053/j.semtcvs.2018.07.010

An anomalous left coronary arising from the pulmonary artery (ALCAPA) in hypoplastic left heart syndrome (HLHS) is a very rare congenital malformation. The Norwood procedure and simultaneous direct reimplantation of the left coronary artery (LCA) to the ascending aorta have been previously used for treatment of ALCAPA, although mortality was very high, because it is difficult to reimplant the LCA to the neoaortic root without distortion or tension. We chose the modified Norwood procedure without reimplantation of the LCA to the neoaortic root, and 4-month-old male infant survived the operation and waiting Fontan procedure.