Various techniques have been described for management of anomalous origin of the left coronary artery from the pulmonary artery presenting in adults. Three patients, 1 male and 2 females, aged 27–37 years, underwent transpulmonary pericardial patch closure with concomitant left internal thoracic artery anastomosis to the left anterior descending artery, under standard cardiopulmonary bypass, thus creating a two-coronary system. One patient had concomitant mitral valve repair. All 3 survived the operation. Postoperative angiography in 2 patients revealed good antegrade flow with decreased collaterals in one and competitive inhibition with increased collaterals in the other. This procedure is considered to be the safest and simplest in this subset of patients.
Get full access to this article
View all access options for this article.
References
1.
SinghTPCarliMFSullivanNMLeonenMFMorrowWR. Myocardial flow reserve in long-term survivors of reports of anomalous left coronary artery from pulmonary artery. J Am Coll Cardiol1998; 31:437–43.
2.
MoodieDSFyfeDGillCCCookSALytleBWTaylorPC. Anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome) in adult patients: Long-term follow-up after surgery. Am Heart J1983; 106:381–8.
3.
CherianKMBharatiSRaoSG. Surgical correction of anomalous origin of the left coronary artery from the pulmonary artery. J Card Surg1994; 9:381–91.
4.
Alexi-MeskishviliVBergerFWengYLangePEHetzerR. Anomalous origin of the left coronary artery from the pulmonary artery in adults. J Card Surg1995; 10:309–15.
5.
FierensCBudtsWDenefBVan de WerfF. A 72-year-old women with ALCAPA. Heart2000; 83:E2.
6.
SivasubramanianSKrishnamurthySMThirumalaiPAlagesanRViswakumarSSukumarA. Anomalous origin of the left coronary artery from pulmonary artery: Is reconstruction of a double coronary artery system always necessary?J Thorac Cardiovasc Surg1996; 111:901–3.
7.
ChanRKHareDLBuxtonBF. Anomalous left main coronary artery arising from the pulmonary artery in an adult: Treatment by internal mammary artery grafting. J Thorac Cardiovasc Surg1995; 109:393–4.
8.
NairKKZismanLSLaderEDimovaACanverCC. Heart transplant for anomalous origin of left coronary artery from pulmonary artery. Ann Thorac Surg2003; 75:282–4.
9.
BackerCLStoutMJZalesVRMusterAJWeigelTJIdrissFS. Anomalous origin of the left coronary artery. A twenty-year review of surgical management. J Thorac Cardiovasc Surg1992; 103:1049–58.
10.
VouhePRTamisierDSidiDVernantFMauriatPPouardP. Anomalous left coronary artery from the pulmonary artery: Results of isolated aortic reimplantation. Ann Thorac Surg1992; 54:621–7.
11.
Dodge-KhatamiAMavroudisCBackerCL. Anomalous origin of the left coronary artery from the pulmonary artery: Collective review of surgical therapy. Ann Thorac Surg2002; 74:946–55.
12.
WilsonCLDlabalPWMcGuireSA. Surgical treatment of anomalous left coronary artery from pulmonary artery: Follow-up in teenagers and adults. Am Heart J1979; 98:440–6.
13.
BuntonRJonasRALangPReinAJCastanedaAR. Anomalous origin of left coronary artery from pulmonary artery. Ligation versus establishment of a two coronary system. J Thorac Cardiovasc Surg1987; 93:103–8.
14.
GardnerTJGreenePSRykielMFBaumgartnerWACameronDECasaleAS. Routine use of the left internal mammary artery in the elderly. Ann Thorac Surg1990; 49:188–94.
15.
KececiogluDVothEMorguetAMunzDLVogtJ. Myocardial ischemia and left ventricular function after ligation of left coronary artery (Bland-White-Garland syndrome): A long-term follow-up. J Thorac Cardiovasc Surg1992; 40:283–7.
16.
KawaraTTayamaEHayashidaNNishimiMAoyagiS. Anomalous origin of the left coronary artery from the pulmonary artery: Successful direct implantation in a 50-year-old man. Ann Thorac Cardiovasc Surg2003; 9:197–201.
17.
SelzmanCHZimmermanMACampbellDN. ALCAPA in an adult with preserved left ventricular function. J Card Surg2003; 18:25–8.
18.
KattachHAnastasiadisKJinXYPillaiR. Two-conduit repair for anomalous origin of the left coronary artery from the pulmonary artery in an adult. J Thorac Cardiovasc Surg2004;128:641–2.
19.
CochraneADColemanDMDavisAMBrizardCPWolfeRKarlTR. Excellent long-term functional outcome after an operation for anomalous left coronary artery from the pulmonary artery. J Thorac Cardiovasc Surg1999; 117:332–42.
