Surgical treatment of anomalous coronary artery arising from the pulmonary artery

• Published in: Interactive cardiovascular and thoracic surgery 2009-01, Vol.8 (1), p.67-69
• Main Authors: Canale, Leonardo S, Monteiro, Andrey J.O, Rangel, Isabela, Wetzel, Evanice, Pinto, Divino F, Barbosa, Rosa C, Meier, Milton A, Marcial, Miguel L.B
• Format: Article
• Language: English
• Subjects: Adolescent; Blood Vessel Prosthesis Implantation; Cardiac Surgical Procedures - adverse effects; Child; Child, Preschool; Coronary Vessel Anomalies - physiopathology; Coronary Vessel Anomalies - surgery; Female; Humans; Infant; Male; Pulmonary Artery - abnormalities; Pulmonary Artery - surgery; Replantation; Stroke Volume; Subclavian Artery - surgery; Time Factors; Treatment Outcome; Ventricular Function, Left
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2008.184903

Department of Cardiac Surgery, Pro-Cardíaco Hospital, General Polidoro Street, 192, Botafogo, Rio de Janeiro, 22280-000 RJ, Brazil *Corresponding author. Vieira Souto Avenue 208/901 Ipanema, Rio de Janeiro, 22420-000 RJ, Brazil. Tel.: [phone]; fax: [phone]. E-mail address : leonardo.canale{at}gmail.com (L.S. Canale). Anomalous coronary arteries arising from the pulmonary trunk is a rare but potentially fatal condition. We report the clinical presentation, surgical treatment and long-term follow-up of seven surgical cases of anomalous left coronary and one case of anomalous right coronary artery arising from the pulmonary artery. Age ranged from 7 months to 13 years (average: 5.09±3.7 years) and weight ranged from 7 to 50 kg (average: 19.9±8.8 kg). Follow-up was 100% complete: average 78 months (S.D.: 52.7 months). Direct reimplantation was the surgical technique in six cases, Takeuchi procedure in one case and subclavian artery interposition in one case. Concomitant mitral valve repair was undertaken in two cases. In two children the coronary artery anomaly was diagnosed and treated only after a first surgery for other congenital heart anomaly. Left ventricle ejection fraction was restored in those cases of pre-operative dysfunction. Mortality was not observed and all children are asymtomatic and free of reoperation. Key Words: Anomalous coronary artery; Congenital heart defects; Left coronary artery; Right coronary artery