[Abnormal origin of the left coronary artery from the pulmonary artery: a retrospective study of 36 cases].
The aim of this study was to show the evolution of diagnostic techniques revealing an abnormal origin of the left coronary artery and present the follow-up results of patients operated for this malformation at different ages. This retrospective study includes 36 children or adults, with a mean age at the moment of of 28 months old, ranging from 7 days to 39 years. In 9% of cases, patients were asymptomatic. Before 1990, 81% of children had a cardiac catheterization, versus 25% after. Indeed, echocardiography with color Doppler enabled the diagnosis of abnormal origin of the left coronary artery in 70% of cases. The pre-operative mortality is at 21% (12.5% after 1990). Twenty-three patients had surgery: left coronary artery reimplantation (n=16), bypass (n=5), at mean of 44 months old for the entire series, but 21 months old after 1990. The follow-up was clinical, ECG and radiographic and echocardiographic after 1975; when possible an exercise test, cardiac nuclear imaging and more recently coronary CT scan and MRI have been performed. In conclusion, children are operated earlier and the follow-up should focus on the detection of occlusion of the re-implanted left coronary artery by echocardiography, with or without stress, exercise test, cardiac nuclear imaging, MRI and sometimes, coronary angiography.
Richard
A
A
Service des maladies cardiovasculaires infantiles et congénitales, Hôpital Cardiologique, bd Jules Leclercq, 59037 Lille cedex. adelarichard@hotmail.com
Godart
F
F
Brevière
G-M
GM
Francart
C
C
Foucher
C
C
Rey
C
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000601:surgery; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed