Surgical repair of anomalous origin of the coronary artery from the pulmonary artery in children.
OBJECTIVE
To evaluate surgical management of children with coronary artery anomalies, including patients with rare abnormalities (left anterior descending artery or right coronary artery originating from the pulmonary artery).


METHODS
A retrospective review of eight patients (aged 2 months--10 yr; median 3.5 yr), treated for coronary artery anomalies between 1989 and 1999. Coronary vessels were reimplanted to the aorta in four children, while the remaining four were subjected to the Takeuchi procedure.


RESULTS
All children survived. None required mechanical circulatory support. In six patients significant mitral valve insufficiency developed, nevertheless, no intraoperative mitral valvuloplasty was performed. Follow-up was 2 months--10 yr. All patients developed normally and are currently in NYHA class I. Echocardiography revealed normal FS and EF values within 1--17 months postoperatively.


CONCLUSIONS
In children with coronary artery anomalies, the best results are achieved with an early diagnosis and aggressive management. In our opinion coronary vessel reimplantation and the Takeuchi procedure yields comparable results.
Malec
E
E
Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Collegium Medicum, Jagiellonian University, 265 Wielicka Str. 30-663, Kraków, Poland. mimalec@cyf-kr.edu.pl
Zajac
A
A
Mikuta
M
M
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D013318:Stroke Volume; D016019:Survival Analysis; D013536:Suture Techniques; D016896:Treatment Outcome