Coronary anomalies in tetralogy of Fallot - A meta-analysis

被引:29
作者
Koppel, Claire J. [1 ]
Jongbloed, Monique R. M. [1 ,2 ]
Kies, Philippine [1 ]
Hazekamp, Mark G. [3 ]
Mertens, Bart J. A. [4 ]
Schalij, Martin J. [1 ]
Vliegen, Hubert W. [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Cardiol, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Anat & Embryol, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands
[3] Leiden Univ, Med Ctr, Dept Cardiothorac Surg, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
[4] Leiden Univ, Med Ctr, Dept Biomed Data Sci, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands
关键词
Tetralogy of Fallot; Anomalous coronary artery; Conus artery; Coronary arteriovenous fistula; Right ventricular outflow tract; CONGENITAL HEART-DISEASE; PULMONARY-ARTERY; AORTIC ORIGIN; OUTFLOW TRACT; CHILDREN; IDENTIFICATION; DIAGNOSIS; CONDUIT; ANATOMY; PATTERN;
D O I
10.1016/j.ijcard.2020.02.037
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: An anomalous coronary artery is reported in 2% to 23% of patients with tetralogy of Fallot (TOF). Knowledge of coronary anatomy prior to corrective surgery is vital to avoid damage to vessels crossing the right ventricular outflow tract (RVOT). A meta-analysis on the prevalence of anomalous coronary arteries in TOF is lacking to date. Here, an overview of coronary anomalies in TOF is provided and implications for patient management are discussed. Methods: PubMed, Embase and Web of Science were searched. Analysis was done using Revman 5.3 (Cochrane Community, London). The primary analysis focused on the origin and proximal course of the right and left coronary arteries. In addition, the prevalence of large conus arteries and coronary arteriovenous fistulas (CAVF) was calculated. Results: Twenty-eight studies, encompassing 6956 patients, were included; 6% of TOF patients have an anomalous coronary artery. Hereof, 72% cross the RVOT; the majority of the remaining 28% courses behind the aorta. Six percent of patients have a large conus artery and 4% a CAVF. Other coronary anomalies include a left or right coronary artery from the pulmonary trunk or left or right pulmonary artery, coronary tree hypoplasia and anastomoses between coronary and bronchial arteries. Conclusions: The prevalence of coronary anomalies in TOF is 4-6%. In patients with an anomalous coronary artery, 72% cross the RVOT. The combined risk of encountering an anomalous coronary artery or a large conus artery crossing the RVOT is 10.3%. Coronary anatomy should be defined before surgery and the surgical approach adapted accordingly. (c) 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:78 / 85
页数:8
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