title: Oblique coronary artery prolongation approach in anomalous left coronary artery from the pulmonary artery in a low-birth-weight neonate.
abstract: A 19-day-old newborn girl weighing 1.9-kg was born with anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA). Because of the small anatomic structures and long distance between the anomalous origin of the LCA high within the left posterior sinus of the main PA, a simple transfer of the anomalous LCA to the aorta was deemed impossible. A coronary button was created with an oblique flap of tissue cut from the posterior pulmonary arterial wall. An oblique flap was created from the anterior aortic wall. The two flaps were used to create a tubular prolongation that connected the LCA to the aorta. This created a tension-free anastomosis with potential for growth. The aorta and PA were then patched with pericardium. A left coronary angiogram three years after surgery demonstrated a patent coronary tube.
authors: Section of Cardiology, Department of Medicine, Temple University Hospital, Philadelphia, PA, USA.
authors: Joseph J
authors: JJ
authors: Franco
authors: Heart Center, St Christopher's Hospital for Children, Philadelphia, PA, USA igor.mesia@tenethealth.com.
authors: Cesar Igor
authors: CI
authors: Mesia
authors: Section of Cardiology, Department of Medicine, Temple University Hospital, Philadelphia, PA, USA.
authors: Ricardo O
authors: RO
authors: Escarcega
authors: Heart Center, St Christopher's Hospital for Children, Philadelphia, PA, USA.
authors: Randy
authors: R
authors: Stevens
authors: Heart Center, St Christopher's Hospital for Children, Philadelphia, PA, USA.
authors: Achintya
authors: A
authors: Moulick
mesh_terms: D000792:Angiography; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery
keywords: ALCAPA; Takeuchi; coronary anomaly; oblique aortic flap