Maziar Gholampour Dehaki1, Alwaleed Al-Dairy1, Yousef Rezaei2, Alireza Alizadeh Ghavidel2, Gholamreza Omrani2, Nader Givtaj1, Reza Sadat Afjehi1, Hassan Tatari1, Amir Hossein Jalali1, Mohammad Mahdavi3
1 Department of Cardiovascular Surgery, Division of Congenital Cardiac Surgery, Iran University of Medical Sciences, Tehran, Iran
2 Heart Valve Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Department of Pediatric Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Background: Anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation. We sought to evaluate in-hospital and mid-term outcomes of patients with a diagnosis of ALCAPA who underwent surgical repair.
Objectives: The objective of this study is to evaluate the mid-term outcomes of surgical repair of ALCAPA at our center and to analyze the surgical techniques used.
Materials and Methods: In a retrospective study, we analyzed early and mid-term clinical and echocardiographic data to determine the outcomes of patients who underwent surgical repair of ALCAPA in our institution between 2005 and 2015.
Results: Twenty-one patients underwent surgical repair for ALCAPA using aortic reimplantation (n = 10, 47.6%), ostial closure. (n = 8, 38.1%), or ligation. (n = 3, 14.3%). The median age of patients was 24. months. (range 22 days to 51 years). There were 2 (9.5%) in-hospital mortalities in infants undergoing the reimplantation technique. All patients were followed up for a median of 21 months. (range 1–60 months). No patients required reoperation, and there was no mortality from discharge to mid-term follow-up. Severe early postoperative mitral regurgitation. (MR) was associated with composite end-point, defined as a combination of mortality after surgery, moderate to severe MR, and moderate to severe left ventricular dysfunction at late follow-up. (P = 0.019) while mitral valve repair was not. (P = 0.469).
Conclusion: The surgical management of ALCAPA can be associated with good in-hospital and mid-term outcomes regardless of the age, at which the patient has been operated.
Fellowship in Congenital Cardiac Surgery, Rajaie Cardiovascular Medical and Research Center, Tehran 1996911151
Source of Support: None, Conflict of Interest: None
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