Excellent functional result in children after correction of anomalous origin of left coronary artery from the pulmonary artery--a population-based complete follow-up study.
Surgical strategy to construct a two-coronary system for a patient with anomalous origin of left coronary artery from pulmonary artery (ALCAPA) has evolved with time. Limited long-term follow-up data are available on these children. We report population-based follow-up in children operated on for ALCAPA. In total, 29 patients underwent aortic reimplantation of ALCAPA between 1979 and 2006. Twenty (69%) children were repaired with direct aortic implantation, five (17%) with a modified tubular extension technique, and four (14%) patients with an intrapulmonary baffling technique. Early postoperative mortality (<30 days) was 17%. No late mortality (>30 days) was detected. The median length of follow-up was 11 years (range 10 months-27 years). Global left ventricular function by echocardiography (M-mode) was within normal limits (>30%) in all patients one year after operation. Functionally, 80% of patients were classified in NYHA class I, 20% in NYHA II, and 0% in NYHA classes III/IV at the time of the last examination. Excellent results with good long-term outcome can be achieved in infants with ALCAPA using reimplantation techniques. Normalization of cardiac function is expected within the first year in all operative survivors with a patent coronary system.
Ojala
Tiina
T
Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. tiina.h.ojala@hus.fi
Salminen
Jukka
J
Happonen
Juha-Matti
JM
Pihkala
Jaana
J
Jokinen
Eero
E
Sairanen
Heikki
H
D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011159:Population Surveillance; D011651:Pulmonary Artery / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D020127:Recovery of Function; D012092:Replantation; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left