ANOMALOUS ORIGIN OF THE LEFT CORONARY-ARTERY FROM THE PULMONARY-ARTERY IN ADULTS

被引:66
作者
ALEXIMESKISHVILI, V
BERGER, F
WENG, YG
LANGE, PE
HETZER, R
机构
[1] Departments of Thoracic and Cardiovascular Surgery, German Heart Institute Berlin, Berlin
[2] Departments of Pediatric Cardiology, German Heart Institute Berlin, Berlin
关键词
D O I
10.1111/j.1540-8191.1995.tb00617.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Between March 1986 and December 1994, four adult patients underwent surgery for anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) at the German Heart Institute Berlin. The patients, aged 27, 35, 54, and 60, were all females. ALCAPA was diagnosed 3 to 8 months before surgery. The patients presented with cardiac murmur (two patients), abnormal ECG pattern (two patients), arrhythmia (one patient), and acute myocardial infarction (one patient). During surgery a two coronary system was established either by Takeuchi operation (one patient), interruption of the anomalous vessel and aortocoronary saphenous vein bypass (two patients), or internal mammary artery bypass (one patient). There were no postoperative deaths, however, one patient had to be reoperated because of a recurrent shunt. Clinical improvement was observed in all four patients with disappearance of fatigue, angina, dyspnea, and ischemic ECG changes. Despite having this long-standing congenital heart defect, adult and elderly patients with ALCAPA may benefit from surgical intervention to establish a two coronary system.
引用
收藏
页码:309 / 315
页数:7
相关论文
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  • [1] Roberts WC, Major anomalies of coronary arterial origin seen in adulthood, Am Heart J, 111, pp. 941-963, (1986)
  • [2] Purit CM, Sabiston DC, Origin of the left coronary artery from the pulmonary artery in older adults, J Thorac Cardiovasc Surg, 102, pp. 566-570, (1991)
  • [3] Fernandes ED, Kadivar H, Hallman GL, Et al., Congenital malformation of the coronary arteries: The Texas Heart Institute Experience, Ann Thorac Surg, 54, pp. 732-740, (1992)
  • [4] Alexi-Meskishvili V, Hetzer R, Weng Y, Et al., Anomalous origin of the left coronary artery from the pulmonary artery: Early results with direct aortic reimplantation, J Thorac Cardiovasc Surg, 108, pp. 354-362, (1994)
  • [5] Thomas CS, Campbell WB, Alford WC, Et al., Complete repair of anomalous origin of the left coronary artery in the adult, J Thorac Cardiovasc Surg, 66, pp. 439-446, (1973)
  • [6] Donaldson RM, Raphael M, Radley-Smith R, Et al., Angiographic identification of primary coronary anomalies causing impaired myocardial perfusion, Cathet Cardiovasc Diagn, 9, pp. 237-249, (1983)
  • [7] Pena R, Alcibar J, Cabrera A, Et al., Origin anõmalo de la coronaria en la arteria pulmonar. A proposito de un caso en la edad adulta, Rev Esp Cardiol, 43, pp. 500-502, (1990)
  • [8] Kryne R, Deng MC-HK, Heinrich K-W, Anomalous origin of the left coronary artery from the pulmonary trunk with multiple valvular incompetence, Inter J Cardiol, 24, pp. 367-368, (1989)
  • [9] Letcher JR, McCormick D, Tender S, Et al., Left main coronary arising from the pulmonary trunk in 56‐year‐old patient presenting with acute myocardial infarction, Am J Cardiol, 68, pp. 1257-1258, (1991)
  • [10] Viskin S, Belhassen B, Paredes A, Et al., Anomalous origin of the left coronary artery from the pulmonary artery: Report of an adult with ventricular fibrillation as a presenting symptom, Am Heart J, 124, (1992)