title: Surgical repair of anomalous coronary arteries arising from the opposite sinus of Valsalva in infants and children.
abstract: BACKGROUND
  Unroofing of anomalous coronary artery originating from the opposite sinus of Valsalva has become the procedure of choice for this congenital lesion, with surgery performed in children as young as two years old. An increasing number of this anomaly is diagnosed in infancy with no clear indication whether surgical repair should be done in this age group. This paper reviews our experience with this anomaly, and focuses on its surgical management in infants.
  
  
  METHODS
  Between April 2002 and February 2007, eight patients underwent surgical repair of anomalous coronary artery arising from the opposite sinus of Valsalva and coursing between the aorta and pulmonary artery. Patients' age varied from two months to 28 years with a mean of 11.7 +/- 11.1 years.
  
  
  METHODS
  Surgical repair involved unroofing the intramural segment of the anomalous coronary artery using cardiopulmonary bypass.
  
  
  RESULTS
  Two patients were younger than one year (Group A), and six patients were older than one year (group B). The mean intensive care unit stay was 2.5 +/- 0.7 days for Group A and 2.8 +/- 1.9 for Group B. The mean hospital stay was 4 +/- 1.4 days for Group A and 4.3 +/- 2.4 days for Group B. There was no mortality and no complications. The mean follow-up period is 14 +/- 15.7 months with a range of one to 39 months. At the time of the last follow-up, all patients were asymptomatic in New York Heart Association class I and follow-up echocardiography on six of eight patients showed wide open coronary ostium.
  
  
  CONCLUSIONS
  Unroofing the anomalous coronary artery arising from the opposite sinus of valsalva can be done in infants with minimal morbidity and mortality. Longer follow-up is needed to assess long-term results.
authors: Hope Children Hospital, The Heart Institute for Children, 4440 West 95th Street, Oak Lawn, IL 60453, USA. Chawki@thic.com
authors: Chawki
authors: C
authors: elZein
authors: Ziad
authors: Z
authors: Hanhan
authors: Malek
authors: M
authors: Massad
authors: Mary-Jane
authors: MJ
authors: Barth
authors: Sunthorn
authors: S
authors: Muangmingsuk
authors: Alexander
authors: A
authors: Geha
authors: Anastasios
authors: A
authors: Polimenakos
authors: Michel
authors: M
authors: Ilbawi
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000601:surgery*; D017539:Tunica Intima / Q000601:surgery; D055815:Young Adult