title: Anomalous left coronary artery from the pulmonary artery: intermediate results of coronary elongation.
abstract: A two coronary system is preferred for correcting anomalous left coronary artery from the pulmonary artery (ALCAPA); however, translocation is not always possible. In countries where neonatal arterial switch operations have not been perfected coronary transfer can be difficult. The purpose of this report is to describe the intermediate results using the coronary elongation and translocation technique in developing countries. Records of patients undergoing operation by the International Children's Heart Foundation team were reviewed (April 1993-October 2008) for those undergoing ALCAPA repair. All patients received a 2-D echocardiographic-color Doppler examination prior to discharge and at follow-up. A total of 13 patients were identified, age ranged from 9 days to 41 years. All but one patient were operated upon at one of our affiliate hospitals in Croatia, Belarus, China and Colombia. All patients presented with moderate to severe mitral regurgitation and cardiac failure. Follow-up ranged from six months to 9.5 years postoperatively. Color Doppler showed a patent left coronary artery; echocardiography estimated a normal left ventricular ejection fraction and improved mitral regurgitation in all patients. The technique provides an alternative approach to translocation for ALCAPA in countries where routine neonatal coronary transfer techniques may not be perfected. Intermediate results are comparable to translocation.
authors.affiliation: Department of Surgery, University of Tennessee Health Sciences Center, Memphis, TN 38104, USA. ichfno@aol.com
authors.forename: William M
authors.initials: WM
authors.lastname: Novick
authors.forename: Xiao F
authors.initials: XF
authors.lastname: Li
authors.forename: Darko
authors.initials: D
authors.lastname: Anic
authors.forename: Alexander
authors.initials: A
authors.lastname: Baskevitch
authors.forename: Nestor
authors.initials: N
authors.lastname: Sandoval
authors.forename: Christian L
authors.initials: CL
authors.lastname: Gilbert
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Di Sessa
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D002681:China; D003105:Colombia; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D003906:Developing Countries; D018618:Echocardiography, Doppler, Color; D005061:Europe, Eastern; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014654:Vascular Patency; D016277:Ventricular Function, Left