Postoperative evaluation after end-to-end subclavian-left coronary artery anastomosis in anomalous left coronary artery.
In most instances of anomalous left coronary artery originating from the pulmonary artery, surgical treatment is recommended. Because establishment of a direct systemic to coronary blood flow is expected to provide the best recovery of left ventricular function, various corrective procedures have been proposed. Subclavian-left coronary artery anastomosis appears to be a logical approach. Four patients operated on at Sainte-Justine Hospital, at an average age of 33 months (27 to 44), with an end-to-end subclavian-left coronary artery anastomosis were evaluated 6 to 46 months postoperatively. The anastomosis was patent in all cases. End-diastolic volume index (74.6 +/- 24.7 versus 122.7 +/- 15.3 ml/m2) and ejection fraction (0.58 +/- 0.07 versus 0.33 +/- 0.06) were improved significantly. Subclavian-left coronary artery anastomosis appears to meet the main criteria for an optimal physiologic correction of anomalous left coronary artery: restoration of a two-coronary artery system, improvement of left ventricular function, and likelihood of long-term patency.
Montigny
M
M
Department of Cardiology, Sainte-Justine Hospital, University of Montreal, Quebec, Canada.
Stanley
P
P
Chartrand
C
C
Selman
E
E
Fournier
A
A
Davignon
A
A
D000714:Anastomosis, Surgical / Q000379:methods; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D011184:Postoperative Period; D013318:Stroke Volume / Q000502:physiology; D013348:Subclavian Artery / Q000601:surgery*; D014654:Vascular Patency