Long-Term Outcome of the Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery (ALCAPA) in Children After Cardiac Surgery: A Single-Center Experience

被引：6

作者：

Ismail, Muna ^{[1
]}

Jijeh, Abdulraouf ^{[2
]}

Alhuwaymil, Rathath M. ^{[3
]}

Alahmari, Raneem ^{[3
]}

Alshahrani, Rawan ^{[3
]}

Almutairi, Reem ^{[3
]}

Habshan, Fahad ^{[4
]}

Shaath, Ghassan A. ^{[5
]}

机构：

[1] Minist Natl Guard Hlth Affairs, King Abdulaziz Cardiac Ctr, Cardiac Sci Dept, Pediat Cardiol, Riyadh, Saudi Arabia

[2] Minist Natl Guard Hlth Affairs, Pediat Cardiac Intens Care Unit, Cardiac Sci Dept, Riyadh, Saudi Arabia

[3] King Saud bin Abdulaziz Univ Hlth Sci, Echocardiog Technol, Coll Appl Med Sci, Riyadh, Saudi Arabia

[4] King Abdulaziz Med City Riyadh, King Abdulaziz Cardiac Ctr, Pediat Cardiol, Riyadh, Saudi Arabia

[5] Minist Natl Guard Hlth Affairs, Cardiac Sci Dept, Pediat Cardiac Intens Care Unit, King Abdulaziz Cardiac Ctr, Riyadh, Saudi Arabia

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2020年 / 12卷 / 12期

关键词：

anomalous origin of the left coronary artery from pulmonary artery; children; ejection fraction; fractional shortening; echocardiography; WHITE-GARLAND SYNDROME; SURGICAL INTERVENTION; REPAIR; INFANTS;

D O I：

10.7759/cureus.11829

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary artery anomaly. It induces left ventricular (LV) dysfunction and mitral valve regurgitation (MR). If untreated, survival beyond infancy is rare. The aim of our study was to analyze the outcome in children with ALCAPA after cardiac surgery. Methods We retrospectively reviewed all patients who were diagnosed at our institution with ALCAPA and underwent surgical repair from 1999 to the end of 2018 (for 20 years). We followed LV dimensions, function, the progress of MV regurgitation, and the somatic growth of children after surgical repair. Results Twenty-nine patients underwent ALCAPA repair while 15 (52%) patients were male. The median age at surgical repair was 5.3 (IQR: 3.8-7.4) months and the mean weight was 5.5 +/- 2 kg. Surgical repair was performed in form of coronary reimplantation in 26 (90%) patients and Takeuchi repair in three (10%) patients. Intensive care unit (ICU) stay was eight (IQR: 6-17) days and hospital stay was 15 (IQR: 12-21) days. The follow-up duration was 5 +/- 3.6 years. Echocardiographic parameters started to improve by six weeks after the repair, and they normalized by one year. At the time of surgery ejection fraction (EF) was 34 +/- 17%, fractional shortening (FS) was 15 +/- 10%, and LV inner diameter in diastole (LVIDD) z score was 5.7 +/- 2.8. These parameters improved by one year after surgery to 66 +/- 7%, 34 +/- 6%, and 0 +/- 1.3, respectively. However, somatic growth started to improve six months after surgical repair. MR was moderate to severe in seven (24%) patients at the time of surgery and regressed to no more moderate nor severe MR at the last follow-up. None of the 29 patients died. Conclusions LV systolic function and dimensions start to improve by six weeks after surgery and reach normal values by one year. MR regresses without intervention in correspondence with the regression of LV dimensional parameters. The somatic growth of children improves six months after repair.

引用

页数：8

共 24 条

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