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Anomalous Left Coronary Artery Originating from the Pulmonary Artery

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Surgical Management of Congenital Heart Disease II

Abstract

Anomalous left coronary artery originating from the pulmonary artery, also known as Bland-White-Garland syndrome, is a rare congenital anomaly. This chapter elaborates:

1. Anatomy

2. Indication for surgery

3. Approach and cardiopulmonary bypass strategy

4. Reimplantation of an anomalous left coronary artery originating from the main pulmonary artery directly into the aorta (video)

5. Reimplantation of an anomalous left coronary artery originating from the from the right pulmonary artery directly into the aorta (video)

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Recommended References

  • Allexi-Meskishvili V, Nasseri BA, Nordmayer S et al (2011) Repair of anomalous origin of the left coronary artery from the pulmonary artery in infants and children. J Thorac Cardiovasc Surg 142:868–874.

    Google Scholar 

  • Azakie A, Russel JL, McGrindle BW et al (2003) Anatomic repair of anomalous left coronary artery by aortic reimplantation: early survival, patterns of ventricular recovery and late outcome. Ann Thorac Surg 75:1535–1541

    Article  PubMed  Google Scholar 

  • Backer CL, Hillman N, Dodge-Khatami A et al (2000) Anomalous origin of the left coronary artery from the pulmonary artery: successful surgical strategy without assist devices. Semin Thorac Cardiovasc Surg Pediatr Cardiac Surg Annu 3:165–172.

    Google Scholar 

  • Bland EF, White PD, Garland J (1983) Congenital anomalies of the coronary arteries: report of an unusual case associated with cardiac hypertrophy. Am Heart J 8:787–801.

    Google Scholar 

  • Chang RKR, Allada V (2001) Electrocardiographic and echocardiographic features that distinguish anomalous origin of the left coronary artery from pulmonary artery from idiopathic dilated cardiomyopathy. Pediatr Cardiol 22:3–10.

    Google Scholar 

  • Cochrane AD, Coleman DM, Davis AM et al (1999) Excellent long-term functional outcome after an operation for anomalous left coronary artery from the pulmonary artery. J Thorac Cardiovasc Surg 117:332–342.

    Google Scholar 

  • Delius RE, Caldarone C (2000) Mechanical support of the pediatric cardiac patient. Semin Thorac Cardiovasc Surg Pediatr Cardiac Surg Annu 3:179–185

    Google Scholar 

  • Del Nido PJ, Duncan BW, Mayer JE et al (1999) Left ventricular assist device improves survival in children with left ventricular dysfunction after repair of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg 67:169–172.

    Google Scholar 

  • Dodge-Khatami A, Mavroudis C, Backer CL (2000) Congenital Heart Surgery Nomenclature and Database Project: Anomalies of the Coronary Arteries. Annals 69:270–297

    Google Scholar 

  • Dodge-Khatami A, Mavroudis C, Backer CL (2014) Congenital and acquired coronary artery anomalies in newborns, infants, children, and young adult. In: DaCruz EM, Ivy D, Jagger J (eds) Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive care. Springer Verlag, London, pp 2019–2042

    Chapter  Google Scholar 

  • Edwards JE (1964) The direction of blood flow in coronary arteries arising from the pulmonary trunk. Circulation 29:163–166.

    Google Scholar 

  • Frapier JM, Leclercq F, Bodino M et al (1999) Malignant ventricular arrhythmias revealing anomalous origin of the left coronary artery from the pulmonary artery in two adults. Eur J Cardio-thorac Surg 15:539–541.

    Google Scholar 

  • Galloway AC, Grossi EA, Spencer FC et al (1995) Operative therapy for mitral insufficiency from coronary artery disease. Semin Thorac Cardiovasc Surg 7:227–232.

    Google Scholar 

  • Gaynor WJ (1998) Coronary artery anomalies in children. In: Kaiser LR, Kron IL, Spray TL (eds) Mastery of cardiothoracic surgery. Lippincott-Raven Publishers, Philadelphia, pp 880–893

    Google Scholar 

  • Isomatsu Y, Imai Y, Shin’oka T et al (2001) Surgical intervention for anomalous origin of the left coronary artery from the pulmonary artery: the Tokyo experience. J Thorac Cardiovasc Surg 121:792–797.

    Google Scholar 

  • Lange R, Vogt M, Hörer J et al (2007) Long-term results of repair of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg 83:1463–1471

    Article  PubMed  Google Scholar 

  • Schwartz ML, Jonas RA, Colan SD (1997) Anomalous origin of left coronary artery from pulmonary artery: recovery of left ventricular function after dual coronary repair. J Am Coll Cardiol 30:547–553.

    Google Scholar 

  • Singh TP, DiCarli MF, Sullivan NM et al (1998) Myocardial flow reserve in long-term survivors of repair of anomalous left coronary artery from pulmonary artery. J Am Coll Cardiol 31:437–443.

    Google Scholar 

  • Smith A, Arnold R, Anderson RH et al (1989) Anomalous origin of the left coronary artery from the pulmonary trunk. Anatomic findings in relation to pathophysiology and surgical repair. J Thorac Cardiovasc Surg 98:16–24.

    Google Scholar 

  • Turley K, Szarnicki RJ, Flachsbart KD et al (1995) Aortic implantation is possible in all cases of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg 60:84–89.

    Google Scholar 

  • Vouhé PR, Tamisier D, Sidi D et al (1992) Anomalous left coronary artery from the pulmonary artery: results of isolated aortic reimplantation. Ann Thorac Surg 54:621–627.

    Google Scholar 

  • Yang MF, Xie BQ, Lv XD et al (2012) The role of myocardial viability assessed by perfusion/F-18FDG imaging in children with anomalous origin of the left coronary artery from the pulmonary artery. Clin Nucl Med 37:44–48.

    Google Scholar 

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Reimplantation of an Anomalous Left Coronary Artery Originating from the Main Pulmonary Artery Directly into the Aorta

Clip 1: Preoperative findings.

Clip 2: Orientation and anatomy.

Clip 3: Transection of the pulmonary trunk.

Clip 4: Explantation and mobilization of the left coronary artery.

Clip 5: Reimplantation of the left coronary artery into the ascending aorta.

Clip 6: Reconstruction of the donor area of the pulmonary trunk.

Clip 7: Re-anastomosis of the pulmonary artery trunk.

Clip 8: Final result.

Clip 9: Postoperative findings.

Fullversion

Reimplantation of an Anomalous Left Coronary Artery Originating from the Right Pulmonary Artery Directly into the Aorta

Clip 1: Preoperative findings.

Clip 2: Orientation and anatomy.

Clip 3: Partial transection of the pulmonary trunk.

Clip 4: Identification and mobilization of the left coronary artery.

Clip 5: Opening of the aorta.

Clip 6: Reimplantation of the left coronary artery.

Clip 7: Final result.

Clip 8: Postoperative findings.

Fullversion

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Hraška, V., Murín, P. (2015). Anomalous Left Coronary Artery Originating from the Pulmonary Artery. In: Surgical Management of Congenital Heart Disease II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44070-4_8

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  • DOI: https://doi.org/10.1007/978-3-662-44070-4_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-44069-8

  • Online ISBN: 978-3-662-44070-4

  • eBook Packages: MedicineMedicine (R0)

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