Mid-term outcomes of surgical repair for anomalous origin of the left coronary artery from the pulmonary artery: In infants, children and adults

• Main Authors: Maziar Gholampour Dehaki (Author), Alwaleed Al-Dairy (Author), Yousef Rezaei (Author), Alireza Alizadeh Ghavidel (Author), Gholamreza Omrani (Author), Nader Givtaj (Author), Reza Sadat Afjehi (Author), Hassan Tatari (Author), Amir Hossein Jalali (Author), Mohammad Mahdavi (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2017-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0974-2069; 10.4103/0974-2069.205140
• Keywords: Anomalous origin of left coronary artery from the pulmonary artery; ligation; mitral regurgitation; mitral valve repair; ostial closure; reimplantation; Medicine; R; Pediatrics; RJ1-570; Diseases of the circulatory (Cardiovascular) system; RC666-701
• Source: Annals of Pediatric Cardiology, Vol 10, Iss 2, Pp 137-143 (2017)

Background: Anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation. We sought to evaluate in-hospital and mid-term outcomes of patients with a diagnosis of ALCAPA who underwent surgical repair. Objectives: The objective of this study is to evaluate the mid-term outcomes of surgical repair of ALCAPA at our center and to analyze the surgical techniques used. Materials and Methods: In a retrospective study, we analyzed early and mid-term clinical and echocardiographic data to determine the outcomes of patients who underwent surgical repair of ALCAPA in our institution between 2005 and 2015. Results: Twenty-one patients underwent surgical repair for ALCAPA using aortic reimplantation (n = 10, 47.6%), ostial closure. (n = 8, 38.1%), or ligation. (n = 3, 14.3%). The median age of patients was 24. months. (range 22 days to 51 years). There were 2 (9.5%) in-hospital mortalities in infants undergoing the reimplantation technique. All patients were followed up for a median of 21 months. (range 1-60 months). No patients required reoperation, and there was no mortality from discharge to mid-term follow-up. Severe early postoperative mitral regurgitation. (MR) was associated with composite end-point, defined as a combination of mortality after surgery, moderate to severe MR, and moderate to severe left ventricular dysfunction at late follow-up. (P = 0.019) while mitral valve repair was not. (P = 0.469). Conclusion: The surgical management of ALCAPA can be associated with good in-hospital and mid-term outcomes regardless of the age, at which the patient has been operated.