title: Repair of anomalous coronary artery from the pulmonary artery: A-signal center 20-year experience.
abstract: BACKGROUND
  Anomalous origin of coronary artery from the pulmonary artery (ACAPA) is a rare congenital coronary malformation with a high mortality whether in infants or adult patients. This study reviews 20years of surgical treatment in a single center and aims to establish the optimal surgical strategies for this rare pathology.
  
  
  RESULTS
  From April 1994 to March 2015, 96 consecutive patients aged from 3months to 60years underwent coronary repair surgery. The surgical procedures included ligation (3 cases), ligation along with CABG (6 cases), transpulmonary baffling (Takeuchi Procedure, 14 cases) and directly implantation of the anomalous coronary artery (ACA) into the aorta (73 cases). Postoperative extracorporeal mechanical circulatory support (ECMO) was necessary in 4 cases. Mitral valve repair was performed in 40 patients with moderate or severe mitral regurgitation (MR). Mitral replacement was performed in one patient with severe MR. There were one early and two late deaths. One patient underwent a second operation because Baffle leaks. During mean 10.45±8.96year follow-up (1month-18years), both early and late improvement of left ventricular function was observed in most patients (8 patients lost of follow-up).
  
  
  CONCLUSIONS
  The establishment of a two-coronary system is the main goal of surgical therapy today. In different procedures, the direct implantation of the ACA into the ascending aorta is the best method and has good long-term results. ECMO as a bridge to recovery that will play an integral part in moderns' surgical treatment.
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China.
authors: Jiawei
authors: J
authors: Qiu
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China.
authors: Shoujun
authors: S
authors: Li
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China.
authors: Jun
authors: J
authors: Yan
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China.
authors: Qiang
authors: Q
authors: Wang
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China.
authors: Yunhu
authors: Y
authors: Song
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China.
authors: Hansong
authors: H
authors: Sun
authors: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Fuwai Hospital, 167 Beilishi Rd. Xichen District, Beijing 100037, China. Electronic address: drdianyuanli@163.com.
authors: Dianyuan
authors: D
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Anomalous coronary artery from the pulmonary artery; Congenital heart disease; Coronary anomaly; Surgical treatment