An experience with off pump technique for repair of anomalous left coronary artery from pulmonary artery (ALCAPA)

Autor: Parag S. Bhalgat, Bhushan Chavan, Suresh Joshi, Prasanna Salvi, Abhijeet V. Naik
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Time Factors
RD1-811
Subclavian Artery
030204 cardiovascular system & hematology
Pulmonary Artery
Coronary Angiography
Off pump
law.invention
03 medical and health sciences
Coronary circulation
0302 clinical medicine
Left coronary artery
ALCAPA
law
Internal medicine
medicine.artery
Coronary Circulation
Bland White Garland Syndrome
medicine
Cardiopulmonary bypass
Diseases of the circulatory (Cardiovascular) system
Subclavian bypass
Humans
Heart bypass
Coronary Artery Bypass
Subclavian artery
Retrospective Studies
medicine.diagnostic_test
business.industry
Infant
Coronary Vessels
Surgery
medicine.anatomical_structure
Treatment Outcome
030228 respiratory system
Echocardiography
RC666-701
Angiography
Circulatory system
Pulmonary artery
Cardiology
Female
Original Article
business
Cardiology and Cardiovascular Medicine
Follow-Up Studies
Zdroj: Indian Heart Journal, Vol 68, Iss 5, Pp 704-708 (2016)
ISSN: 0019-4832
DOI: 10.1016/j.ihj.2016.02.002
Popis: Background Anomalous origin of left coronary artery from pulmonary artery is a very rare disease with incidence of one every 300,000 live births. It has a high mortality of 80% in the first year of life. This observational study summarized our experience using the technique of subclavian arterial bypass without the use of cardiopulmonary bypass (CPB) for treatment of this coronary anomaly in pediatric population. The study aims to revive an earlier technique, with modifications, as an alternative to the existing coronary translocation. Methods From 2009 till 2015, six consecutive infants were operated by a single surgeon using subclavian artery to left coronary artery bypass done off pump, to establish a two coronary circulation. Results Five patients had an improvement in their LV ejection fractions at the time of the last follow-up. Angiography done in two cases after 2 and 6 years after surgery revealed good flow in the left coronary artery and good growth in the length of subclavian artery. There was one surgical mortality in this series. Conclusions The technique of off pump subclavian arterial bypass for anomalous origin of the left coronary artery from the pulmonary artery is a viable alternative to the existing standard technique of coronary translocation. It essentially eliminates extracorporeal circulatory support or a left heart bypass that may be needed after coronary translocation. Also, the advantage of avoiding CPB, both in economic terms and also the adverse effects related to use of bypass in this very sick hearts, cannot be disregarded.
Databáze: OpenAIRE
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