Surgical intervention for anomalous origin of left coronary artery from right pulmonary artery with intramural aortic course
Zhang Hui
Cheng Pei
Jin Ge
Luo Yi
Abstract：Objective To explore the experience of surgical treatment for anomalous origin of left coronary artery from the right pulmonary artery with intramural aortic course.Methods Totally 10 patients with anomalous origin of left coronary artery from right pulmonary artery with intramural aortic course from October 2007 to August 2014 underwent surgery;among them,6 cases were complicated with mitral regurgitation (MI) (2 cases of mild MI and 4 cases of moderate-severe MI),5 cases were complicated with left ventricular aneurysm.Before operation,the left ventricular ejection fraction (LVEF) was 34％-64％,the left ventricular fractional shortening (LVFS) was 10％-33％.All patients were reconstructed with double-coronary artery,including direct coronary artery graft and coronary unroofing technique,under general anesthesia with middle thoracic incision.In 6 cases with MI,4 cases with severe MI underwent annuloplasty simultaneously;in patients with ventricular aneurysm,2 cases underwent left ventricular aneurysm excision and 2 cases underwent folding closure simultaneously.Results Two cases were died from low cardiac output syndrome after operation.Eight cases survived and were followed-up for 13-72 months,showing good blood flow of left coronary artery and improved cardiac function,with LVEF of 53％-72％ and LVFS of 27％-40％.In 4 cases undergoing annuloplasty,MI was disappeared in 2 cases and turned to mild in 2 cases;in 4 cases undergoing ventricular aneurysm surgery,the ventricular wall motion abnormalities was significantly narrowed down in 3 patients after ventricular aneurysm repaired.No patient need reoperation.Conclusions Anomalous origin of left coronary artery from the right pulmonary artery is rare,usually combined with intramural aortic course.According to the anatomical type,different coronary transplantation methods can obtain satisfactory effect,but the long-term effect still need further follow-up.
Keywords：Anomalous origin of the left coronary arteryRight pulmonary arteryIntramural aortic courseSurgical intervention
Publication Date：2016-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 169-172 )