Presence of reduced regional left ventricular function even in the absence of left ventricular wall scar tissue in the long term after repair of an anomalous left coronary artery from the pulmonary artery

2017 ◽  
Vol 28 (2) ◽  
pp. 200-207
Author(s):  
Sarah Nordmeyer ◽  
Boris Schmitt ◽  
Boris Nasseri ◽  
Vladimir Alexi-Meskishvili ◽  
Titus Kuehne ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Scar Tissue ◽  
Left Ventricular ◽  
Left Ventricular Wall ◽  
Anomalous Origin ◽  
Relative Reduction ◽  
Ventricular Wall ◽  
Regional Left Ventricular Function

AbstractBackgroundWe sought to assess left ventricular regional function in patients with and without left ventricular wall scar tissue in the long term after repair of an anomalous origin of the left coronary artery from the pulmonary artery.MethodsA total of 20 patients aged 12.8±7.4 years were assessed 10 (0.5–17) years after the repair of an anomalous origin of the left coronary artery from the pulmonary artery; of them, 10 (50%) patients showed left ventricular wall scar tissue on current cardiac MRI. Left ventricular regional function was assessed by two-dimensional speckle-tracking echocardiography in 10 patients with scar tissue and 10 patients without scar tissue and in 10 age-matched controls.ResultsIn patients with scar tissue, MRI-derived left ventricular ejection fraction was significantly reduced compared with that in patients without scar tissue (51 versus 61%, p<0.05), and echocardiography-derived longitudinal strain was significantly reduced in five of six left ventricular areas compared with that in healthy controls (average relative reduction, 46%; p<0.05). In patients without scar tissue, longitudinal strain was significantly reduced in two of six left ventricular areas (average relative reduction, 23%; p<0.05) and circumferential strain was reduced in one of six left ventricular areas (relative reduction, 56%; p<0.05) compared with that in healthy controls.ConclusionsRegional left ventricular function is reduced even in patients without left ventricular wall scar tissue late after successful repair of an anomalous origin of the left coronary artery from the pulmonary artery. This highlights the need for meticulous lifelong follow-up in all patients with a repaired anomalous origin of the left coronary artery from the pulmonary artery.

Outcomes of surgical repair of anomalous origin of the left coronary artery from the pulmonary artery in infants and children

2021 ◽  
pp. 1-6
Author(s):  
Tong Feng ◽  
Guo Zhangke ◽  
Bai Song ◽  
Fan Fan ◽  
Zhen Jia ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Anomalous Origin ◽  
Dimension Index

Abstract Objectives: Anomalous origin of the left coronary artery from the pulmonary artery is associated with high mortality if not timely surgery. We reviewed our experience with anomalous origin of the left coronary artery from the pulmonary artery to assess the preoperative variables predictive of outcome and post-operative recovery of left ventricular function. Methods: A retrospective review was conducted and collected data from patients who underwent anomalous origin of the left coronary artery from the pulmonary artery repair at our institute from April 2005 to December 2019. Left ventricular function was assessed by ejection fraction and the left ventricular end-diastolic dimension index. The outcomes of reimplantation repair were analysed. Results: A total of 30 consecutive patients underwent anomalous origin of the left coronary artery from the pulmonary artery repair, with a median age of 14.7 months (range, 1.5–59.6 months), including 14 females (46.67%). Surgery was performed with direct coronary reimplantation in 12 patients (40%) and the coronary lengthening technique in 18 (60%). Twelve patients had concomitant mitral annuloplasty. There were two in-hospital deaths (6.67%), no patients required mechanical support, and no late deaths occurred. Follow-up echocardiograms demonstrated significant improvement between the post-operative time point and the last follow-up in ejection fraction (49.43%±19.92% vs 60.21%±8.27%, p < 0.01) and in moderate or more severe mitral regurgitation (19/30 vs 5/28, p < 0.01). The left ventricular end-diastolic dimension index decreased from 101.91 ± 23.07 to 65.06 ± 12.82 (p < 0.01). Conclusions: Surgical repair of anomalous origin of the left coronary artery from the pulmonary artery has good mid-term results with low mortality and reintervention rates. The coronary lengthening technique has good operability and leads to excellent cardiac recovery. The decision to concomitantly correct mitral regurgitation should be flexible and be based on the pathological changes of the mitral valve and the degree of mitral regurgitation.

scholarly journals Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery As a Rare Cause of Left Ventricular Dysfunction

2019 ◽  
Vol 12 (12) ◽  
Author(s):  
Ligia Lopes Balsalobre Trevizan ◽  
Amit Nussbacher ◽  
Maria Carolina Bueno da Silva ◽  
Walther Yoshiharu Ishikawa ◽  
Sergio Almeida de Oliveira ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Ventricular Dysfunction ◽  
Left Coronary Artery ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Anomalous Origin

Role of speckle tracking echocardiography in the assessment of post-repair left ventricular function in patients with late presentation of anomalous origin of the left coronary artery from the pulmonary artery

2014 ◽  
Vol 25 (5) ◽  
pp. 969-975 ◽  
Author(s):  
Gholamhosein Ajami ◽  
Mohammad R. Edraki ◽  
Ali R. Moarref ◽  
Ahmad A. Amirghofran ◽  
Mohammad Borzouee ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Pulmonary Artery ◽  
Speckle Tracking ◽  
Left Coronary Artery ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Anomalous Origin ◽  
Control Group

AbstractThe aim of this study was to determine the left ventricular myocardial deformation and segmental myocardial dysfunction by speckle tracking echocardiography and tissue Doppler imaging among the operated patients with anomalous origin of the left coronary artery from the pulmonary artery. The study was conducted on 12 patients diagnosed with anomalous origin of the left coronary artery from the pulmonary artery, who had been operated upon between 2001 and 2013 at the medical centres of Shiraz University of Medical Sciences, Shiraz, Iran. The mean age of the patients at the time of surgical correction was 12.6 years ranging from 6 months to 43 years, and the duration of postoperative follow-up was between 1 and 12 years. Comparison of the strain rate between the patients with acceptable ejection fraction and the control group by tissue Doppler imaging showed significant differences between the two groups regarding the lateral wall (p<0.001), but not the septal wall of the left ventricle (p=0.65). Moreover, the strain values by the speckle tracking method revealed significant differences between the patient and the control group regarding the global strain (p=0.016) and anterior, lateral, and posterior segments of the left ventricle. Although postoperative conventional echocardiography revealed normal global left ventricular function with acceptable ejection fraction, abnormal myocardial deformation of the variable segments of the left ventricle with regional and global myocardial dysfunction were well defined by speckle tracking echocardiography.

ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY (ADULT TYPE)

PEDIATRICS ◽  
1962 ◽  
Vol 29 (2) ◽  
pp. 274-282
Author(s):  
M. H. Agustsson ◽  
B. M. Gasul ◽  
R. Lundquist
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Clinical Findings ◽  
Left Ventricular ◽  
Anomalous Origin ◽  
White Female ◽  
Adult Type ◽  
Anomalous Coronary ◽  
Anomalous Left Coronary

The case of a 7-year-old white female with an anomalous left coronary artery from the pulmonary artery is presented. The clinical findings of an asymptomatic patient with a continuous murmur at the left lower strenal border, with left ventricular hypertrophy by roentgenography and electrocardiography raised the suspicion of an aortic fistula, which was then investigated by retrograde aortography. The aortogram demonstrated the anomalous origin of the left coronary artery with retrograde flow into the pulmonary artery. The age and circumstances of death in previously reported cases indicate that the so-called adult type is not a benign disease. The diagnosis of an anomalous coronary artery from the pulmonary artery is at any age an indication for consideration of surgical intervention.

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