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Two-Coronary Repair for Anomalous Left Coronary Artery from Pulmonary Artery

Department of Cardiothoracic and Vascular Surgery Cardiothoracic Sciences Centre All India Institute of Medical Sciences New Delhi, India

For reprint information contact: Anil Bhan, MCh Tel: 91 11 686 4851 or 656 1123 Fax: 91 11 686 2663 email: anil_bhan{at}hotmail.com Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Between January 1989 and December 1998, 13 patients (7 males) aged 3 months to 32 years, underwent surgery for anomalous left coronary artery from the pulmonary artery. Eight presented with congestive cardiac failure and all had evidence of left ventricular dysfunction. One patient had associated tetralogy of Fallot. Preoperative diagnosis was established by echocardiography and cineangiography. Nine patients underwent Takeuchi repair and 4 had direct implantation of the anomalous artery into the aorta. There were 2 postoperative deaths due to low cardiac output. In survivors, serial echocardiograms demonstrated significant improvement in left ventricular function 3 months to 10 years after surgery. Postoperative angiograms in 4 patients showed a patent aortocoronary tunnel in 3 who underwent Takeuchi repair and a patent aortocoronary anastomosis in one who had direct implantation of the anomalous artery into the aorta. It was concluded that early establishment of a two-coronary system gave gratifying short-term and long-term results.

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