Emin Can ATA, Halil TÜRKOĞLU, Korhan ERKANLI, Erkan YILDIZ

Pulmoner arterden çıkan sol koroner arter anomalisi olan bir hastaya yeni cerrahi yaklaşım: Olgu sunumu

Ana pulmoner arterden çıkan sol ana koroner arter anormalisi, çocuklarda çok nadir görülen bir doğuştan kalp hastalığıdır. Ölümcül iskemik ve aritmik komplikasyonlar genellikle pulmoner vasküler direncin düştüğü ve sol koroner arter akımının azaldığı erken bebeklik döneminde ortaya çıkar. Yaygın kollateral koroner arter dolaşım gelişirse, hastaların yaklaşık %10’u çocukluk ve yetişkinlik çağına ulaşır. Bu yazıda, 10 yaşındaki bir hastada sol internal mamaryan arterin sol ana koroner artere uygulanan uç uca anastomoz tekniğimiz sunuldu.

A new surgical approach to a patient with anomalous origin of left coronary artery from pulmonary artery: A case report

Anomalous origin of the left main coronary artery from the mainpulmonary artery is a very rarely seen congenital heart diseasein children. Fatal ischemic and arrhythmic complicationsusually occur during early infancy, when pulmonary vascularresistance falls and left coronary artery flow decreases. Nearly10% of patients reach childhood and adulthood, if extensivecollateral coronary artery circulation develops. In this article,we report our end-to-end anastomosis technique of the leftinternal mammary artery to the left main coronary artery ina-10-year-old patient.

PDF

___

1. Hoashi T, Kagisaki K, Okuda N, Shiraishi I, Yagihara T, Ichikawa H. Indication of Takeuchi technique for patients with anomalous origin of the left coronary artery from the pulmonary artery. Circ J 2013;77:1202-7.
2. Ceylan Ö, Örün UA, Koç M, Özgür S, Doğan V, Karademir S, et al. Anomalous coronary artery originating from the pulmonary artery: a report of four cases. Turk Gogus Kalp Dama 2013;21:122-6.
3. Naimo PS, Fricke TA, d’Udekem Y, Cochrane AD, Bullock A, Robertson T, et al. Surgical intervention for anomalous origin of left coronary artery from the pulmonary artery in children: A long-term follow-up. Ann Thorac Surg 2016;101:1842-8.
4. Sarıoğlu T, Yalçınbaş YK, Erek E, Arnaz A, Türkekul Y, Avşar MK. Anomalous left coronary artery originating from pulmonary artery: recovery of left ventricular function after dual coronary system restoration and clinical results. Turk Gogus Kalp Dama 2013;21:1-6.
5. Kitamura S, Seki T, Kawachi K, Morita R, Kawata T, Mizuguchi K, et al. Excellent patency and growth potential of internal mammary artery grafts in pediatric coronary artery bypass surgery. New evidence for a “live” conduit. Circulation 1988;78:I129-39.
6. Georgiev SG, Lazarov SD, Mitev ID, Latcheva AZ, Christov GA, Velkovski IG, et al. Left ventricular and mitral valve function long after repair of left anomalous coronary artery from the pulmonary artery: Recovery years after severe ischemia. World J Pediatr Congenit Heart Surg 2012;3:321-7.
7. Lange R, Cleuziou J, Krane M, Ewert P, Pabst von Ohain J, Beran E, et al. Long-term outcome after anomalous left coronary artery from the pulmonary artery repair: a 40-year single-centre experience. Eur J Cardiothorac Surg 2018;53:732-9.